| NPI | 1467276592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BOLTER Owner/Addiction Specialist 402-200-3808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2026-03-25 |