| NPI | 1699367615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ARLENE TUCKER Administrator 319-364-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |