| NPI | 1366568065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA GRAY Executive Director 515-288-1981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: IA 77PM29) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: IA 1285) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |