| NPI | 1053157529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI MIMICK Behavioral Health Practitioner 402-937-0426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |