| NPI | 1174704589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY LEE MCCONVILLE Counselor 308-345-4067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 8338) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2007-11-14 |