| NPI | 1679985634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENORA D MEAD Organizer 402-740-4879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 492) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NE 3326) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-06-25 |