| NPI | 1508492745 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JIM P WEISS Director Of Quality Management 402-339-1436  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic | 
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | 
| Enumeration Date | 2020-03-19 | 
| Last Update Date | 2021-08-05 |