NPI | 1790983021 |
---|---|
Doing Business As | CHILDSERVE JOHNSTON HOME |
Entity Type | Organization |
Authorized Contact | RODNEY WILDRICK Director Of Accounting 515-727-1468 |
Organization Subpart ? | Yes |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: IA 771151) |
Enumeration Date | 2007-07-09 |
Last Update Date | 2007-07-23 |