| NPI | 1891480141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE COOLEY Director 712-243-5091 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-04-11 |