| NPI | 1003078437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY STONEWALL HOLLIST President 402-202-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 272) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-06-26 |