| NPI | 1366199259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL MEIBOS Director 385-327-7299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |