| NPI | 1073945739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KATHLEEN BEECHAM Consultant 402-676-2069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE CDHS201301) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |