| NPI | 1669100509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BIGELOW Owner 319-610-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-10-13 |