| NPI | 1427221647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN TRANE Director 319-524-3560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: IA pending) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |