| NPI | 1710126586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN BECKER Business Manager 319-235-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: IA 1236) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-02-18 |