| NPI | 1063839595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTY SHULTZ President 308-627-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: NE 1219) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2025-05-08 |