| NPI | 1821136813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN WILSON VP Accounting 402-896-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |