| NPI | 1447600069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD J LIESKE Therapist 308-532-0083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 10874) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |