| NPI | 1487289252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE CHRISTOPHERSON Practice Manager 712-490-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |