| NPI | 1013715416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GBENADE K. EDOH Director 402-706-8625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Mentally Retarded |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-03-04 |