| NPI | 1851269542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNEY MARSHMAN Credentialing/Billing Specialist 515-509-3497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-10-25 |
| Last Update Date | 2025-12-17 |