| NPI | 1093150047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY POTTER Owner 308-236-0726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1010) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NE 1010) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2016-09-26 |