| NPI | 1962909085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SOLOMON Director Of Finance 402-742-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: CO 36358851) |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: CO 36358851) |
| 376J00000X Homemaker (Licence: CO 36358851) | |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-12 |