| NPI | 1568652162 |
|---|---|
| Other Name | COS |
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD BUSTAMANTE Clinic Director 515-309-1204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |