| NPI | 1568191849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAYTON JIBRI HOGAN CEO/Owner 402-819-9712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2023-12-11 |