| NPI | 1720165897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE RENKEN Out Patient Business Manager 712-293-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 28883) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA 28358) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-11-14 |