| NPI | 1710366091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRA TALBOTT Owner 402-850-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2013) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 984) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |