| NPI | 1609634153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD LARS PETERSON Owner 515-669-2592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-11 |