| NPI | 1174784821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI LYNNE TACKETT-NEWBURG Clinical Therapist 402-932-2296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 293) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |