| NPI | 1982245403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSAE WAGNER CEO/ Owner 319-929-8702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2019-10-06 |
| Last Update Date | 2022-06-06 |