| NPI | 1447614615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALCOLM LEAL-CASTANEDA Practice Manager 308-675-1931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 111197) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |