| Organization Name: | LEE WOLF |
| NPI Number: | 1598988743 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEE WOLF (OWNER) |
| Mailing Address: | 4066 320th St Mapleton |
| State: | IA US |
| Postal Code: | 510348005 |
| Phone Number: | 7128832893 |
| Fax Number: | 7128832894 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 06/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385HR2055X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | Respite Care, Mental Illness, Child |
| Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |