| NPI | 1578094512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WILES Clinical Director 402-964-2092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE P-1458) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |