| NPI | 1437997038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN COLWICK Billing Coordinator 402-830-0308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2025-10-17 |