| NPI | 1932221611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD BEVERIDGE Director 515-247-3265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |