| NPI | 1538387857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY WILDRICK Director Of Accounting 515-727-1468 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: IA 770916) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-10 |