| NPI | 1205838083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEANNE LARSON EMERTON Director 308-381-7487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2013-12-08 |