| NPI | 1871055129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOSHA M JACKSON Licensed Clinician Social Worker 402-469-6899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-04 |