| NPI | 1285178087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA MARIE NORDYKE KING Limhp 402-309-3892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1499) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |