| NPI | 1417172024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN WILSON VP Accounting 402-896-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |