| NPI | 1801784855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERICK MBACHAM Director 515-525-3669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-06-26 |