| NPI | 1114378833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIA RIVERA RIVERA CEO 308-383-2208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 10888) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NE P-1111) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |