| NPI | 1760680409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY DAWN KOENEN President 402-502-1024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 1028) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |