| NPI | 1689762882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNEETA L WAGONER Agency Director 712-542-3501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-12-18 |