| NPI | 1518975770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D NELSON Administrator 319-472-2671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IA 060691) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IA 060691) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-08-22 |