| NPI | 1700750916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MARIE FLOREZ Administrative Manager 308-218-6045 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-10-01 |
| Last Update Date | 2025-10-01 |