| NPI | 1548404445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SCORZA Branch Director 712-737-4831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NE 35396374) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-04-23 |