| NPI | 1922522986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY METSCHKE Ladc 402-646-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |