| NPI | 1366507790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM BARKELY Controller 515-576-7261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IA 1254) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2019-09-04 |