| NPI | 1285011239 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | AMBER DAWN JURGENSMEIER Clinical Social Worker 402-340-4909  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 946)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 1317)  | 
| Enumeration Date | 2015-04-29 | 
| Last Update Date | 2015-04-29 |