| NPI | 1407070808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE MCQUEEN Administrator 712-744-3453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IA R390) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IA R390) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2025-09-11 |