| NPI | 1861945305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY L GAY Director 319-404-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |