| NPI | 1952586331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ALEXANDRIA SHORE Billing Specialist 308-221-6820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2023-01-30 |