| NPI | 1992470488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIGISTI HISMITH Executive Direct 319-669-9312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-18 |