| NPI | 1801302948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE S HEATON Owner 402-617-0317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NE 4845) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: NE 4845) |
| 251S00000X Community/Behavioral Health (Licence: NE 4845) | |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: NE 4845) | |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2018-01-23 |