| NPI | 1003219361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL S LEACH Sole Member 308-778-6621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1077) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |