| NPI | 1093259491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE RICHARDSON Owner 402-470-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 3827) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NE 147) |
| 251S00000X Community/Behavioral Health (Licence: NE 1136) | |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |