| NPI | 1720854847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE IRENE ELIZABETH KRUCKENBERG CEO 515-576-6500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |