| NPI | 1659928331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN RATLIFF Owner 712-355-1526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2019-08-19 |