| NPI | 1447017579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN SMITH Owner 308-390-9347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-03-05 |
| Last Update Date | 2024-03-05 |