| NPI | 1154975761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ELLISON Owner And Provider 402-680-2699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2022-09-13 |