| NPI | 1538889563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN S BERKE Owner 712-600-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |