| NPI | 1013081389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOLENE MARIE HERRELL Director Of Operations 308-398-4662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NV 2629) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |