| NPI | 1922545334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN WAGNER Owner 402-469-0183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NE 4826) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2024-01-25 |