| NPI | 1841722873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKA C JOHNSON Billing/Credentialing Spec. 402-885-7672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 4937) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1393) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2022-03-28 |