| NPI | 1477713162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN MICHAEL WILLIAMS Program Director 712-243-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 1319) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |