| NPI | 1184099004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE TOLSTON Managing Member 402-210-3675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NE 23879) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |