| NPI | 1134642341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL R. CLAYMORE Senior VP Of Clinical Integration 308-568-7197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-07-21 |