| NPI | 1235697053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CLARK Owner 402-616-5139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2023-08-04 |