| NPI | 1609998137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEN PEARSON CEO 515-280-4908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: IA 1292) |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-08-22 |