| NPI | 1972047074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDY J WHITCOMF Owner/Operator 402-374-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 436) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |