| NPI | 1023233632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI SOLE Director Of Billing 402-896-5827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-11-04 |