| NPI | 1063839595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTY SHULTZ President 308-627-6119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NE 1219) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NE 1219) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-03-21 |
| Last Update Date | 2023-09-06 |