| NPI | 1457829913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN S MARCUM Owner/Admin 712-986-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2024-07-03 |