| NPI | 1508955485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LYNN MCSTOCKARD Director Of Billing 641-472-1684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2011-06-08 |