| NPI | 1457571416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN KINNEY Accounting Supervisior 563-264-9260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 1279) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-11-20 |