| NPI | 1487986600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY KATHERYN ANDERSON Program Director 402-641-6245 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NE P-824) |
| Enumeration Date | 2010-02-13 |
| Last Update Date | 2011-02-06 |