| NPI | 1891870374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE RENAE HANKS Executive Director 712-898-1245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IA 2984003) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |