NPI | 1497354773 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANCIE TUESCHER Chief Compliance Officer 563-583-7357 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2020-10-19 |
Last Update Date | 2021-01-05 |