| NPI | 1205343217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS Z MAXSON Manager 308-233-0977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2017-12-29 |