| NPI | 1366772378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA HUERTA Lpn 402-885-3363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NE 21147) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2010-06-22 |