| NPI | 1235648668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE DIANE ROSS Licensed Clinical Social Worker 402-727-1681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NE 918) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NE 918) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-11-07 |