| NPI | 1861658536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L MOATS Organizer 515-971-7605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 04652) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2008-09-15 |