| NPI | 1780747915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK BROWN Executive Director 641-228-4842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: IA 450611) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |