| NPI | 1114789708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR MALLIN Mental Health Therapist 402-905-2545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-09-06 |