| NPI | 1063990984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN THOMAS EVANS Owner 402-330-1537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1692) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1189) | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |