| NPI | 1669896346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT L RICE Director 712-256-4420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: IA 001733) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: IA 001733) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |