| NPI | 1467874974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL BERGMAN CEO 641-752-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001734) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-01-17 |