| NPI | 1568048726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA HUMPHREY Account Manager 402-504-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2022-08-26 |