| NPI | 1154011153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEENA SHANE' REYNOLDS Director 402-598-0517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-05-11 |