| NPI | 1750616652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE BOOTH Intake 319-398-3562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 089387) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |