| NPI | 1255893186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL HOLLOWAY Credentialling Agent 402-694-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-03-14 |