| NPI | 1780882571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JAMES MCKENZIE Owner 402-502-1024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NE LMHP2211) |
| Additional Taxonomies | 251S00000X (Licence: NE LCSW995) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |