| NPI | 1548122302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER RAE SHUPE Owner/Provider 712-229-5381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-12-01 |
| Last Update Date | 2025-12-01 |