| NPI | 1417497355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KENNETH SHAW Clinical Social Worker/Owner 402-881-5475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NE 1142 2826 1275) |
| Enumeration Date | 2017-02-26 |
| Last Update Date | 2017-02-26 |