| NPI | 1174663801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN WILSON VP Accounting 402-896-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: IA 2439232) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |