| NPI | 1063063014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBERLY WIESE Owner 402-201-7852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2019-09-21 |
| Last Update Date | 2019-09-21 |