NPI | 1922746502 |
---|---|
Entity Type | Organization |
Authorized Contact | LATRICE D. MARTIN Owner 402-431-2115 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261Q00000X Clinic/Center |
261QM2500X Clinic/Center, Medical Specialty | |
363LF0000X Nurse Practitioner, Family | |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2022-05-24 |
Last Update Date | 2024-08-10 |