| NPI | 1992832356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD M MEYER Administrator 319-385-2046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: IA 440765) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2009-11-20 |