| NPI | 1437591310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN LEBAHN Director 641-672-3159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 007787) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2015-03-03 |