| NPI | 1649569625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER JOHNSON Owner 319-321-9253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 00228) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-06-01 |