| NPI | 1801952205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON FELIX MELLADO Executive Director 319-351-9760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IA 1261) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |