| NPI | 1942073788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIEVIA QUATREA RUSH-WILKS Owner 402-219-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-02 |