| NPI | 1770201675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME MILLER Executive Director/Counselor 515-865-7783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |