| NPI | 1114660594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MEEKS Business Manager 308-282-1322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |