| NPI | 1619410735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA CASTRO-MOCTEZUMA Executive Director 712-522-0947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 001675) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |