| NPI | 1144752189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MOSELEY Sole Prop 402-680-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 10232) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |