| NPI | 1205594280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB AARON HILE Qido 402-465-5664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2021-12-07 |