| NPI | 1861698110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA LEONHARDT Owner 308-696-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 419) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |