| NPI | 1912553546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMESON MAYBERRY Organizer/Therapist 641-430-5868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |