| NPI | 1669125159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DWAYNE CAMERON Psychotherapist/Principal Organizer 515-557-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-03 |