| NPI | 1770300865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONTASHA NINA-MARIE JOHNSON Authorized Oddicial 402-415-9639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-09-20 |
| Last Update Date | 2024-09-20 |