| NPI | 1780024976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEB VAVRA Administrative Coordinator 308-627-6126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NE 8102) |
| Additional Taxonomies | 251S00000X (Licence: NE 3529) |
| 251S00000X (Licence: NE 1321) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |