NPI | 1003256082 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE ANN JENSEN President/Owner 712-301-4518 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: NE 569) |
Additional Taxonomies | 251S00000X (Licence: NE 901) |
Enumeration Date | 2013-07-05 |
Last Update Date | 2014-12-31 |