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Organization

LEE WOLF

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEE WOLF (OWNER)
(712) 883-2893
Entity
Organization

Contact information

Practice address
4066 320TH ST, MAPLETON, IA 51034-8005
(712) 883-2893
(712) 883-2894
Mailing address
4066 320TH ST, MAPLETON, IA 51034-8005
(712) 883-2893
(712) 883-2894

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0479691
IA
Enumeration date
04/10/2007
Last updated
06/23/2008
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