| NPI | 1073975249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY E CARLSON Provider/Owner 402-721-8802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 18) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 683) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2026-06-06 |