| NPI | 1619379724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DEE LARSEN A RN P 515-250-4194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IA G087693) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2014-09-19 |