| NPI | 1578531877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER L BRANTNER Executive Director 641-782-8457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2014-12-12 |