| NPI | 1750533113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDE FARRAR Sole Proprietor 308-430-3918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 8341) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |