| NPI | 1528827219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LOUISE WAGNER CEO 319-481-9203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-15 |