| NPI | 1063752863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GUROCK Director Of Therapy 402-214-6949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 818) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 3460) |
| Enumeration Date | 2013-02-15 |
| Last Update Date | 2017-03-07 |