| NPI | 1508996901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT KEITH KELLEY Administrator 641-673-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: IA 620603) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |