| NPI | 1023747615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GRANGER Owner 402-650-9601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-06-08 |