Provider First Line Business Practice Location Address:
GENESIS MENTAL HEALTH ASSOC
Provider Second Line Business Practice Location Address:
1218 CENTRAL AVE
Provider Business Practice Location Address City Name:
FORT DODGE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
514-571-4422
Provider Business Practice Location Address Fax Number:
515-576-6441
Provider Enumeration Date:
05/02/2006