| NPI | 1841712445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE E RILEY Owner 308-398-0350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1784) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1149) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2022-07-21 |