| NPI | 1659880425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER STEWART GRAY CEO 402-575-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 109) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 109) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2017-09-25 |