| NPI | 1790153617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL ALAN CRARY Co Owner 402-812-5939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 1-14-9679) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2018-05-04 |