| NPI | 1811311665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN ORA CROUCH Owner 308-237-6865 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 35) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 296) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2023-09-22 |