| NPI | 1619322542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DAVID WALLS Owner/President 402-430-6912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 244) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |