| Aspire And Revive Therapy Llc | |
|
3677 N 129th St Omaha NE 68164-5211 | |
| (402) 715-0382 | |
| Not Available |
| Full Name | Aspire And Revive Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3677 N 129th St, Omaha, Nebraska |
| Authorized Official Name and Position | Jennifer Richey (OWNER) |
| Authorized Official Contact | 4027150382 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspire And Revive Therapy Llc 530 Cordes Dr Apt 3 Papillion NE 68046-2749 Ph: (402) 715-0382 | Aspire And Revive Therapy Llc 3677 N 129th St Omaha NE 68164-5211 Ph: (402) 715-0382 |
| NPI Number | 1518666700 |
|---|---|
| Provider Enumeration Date | 02/27/2023 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Medicare PECOS PAC ID | 7810361680 |
|---|---|
| Medicare Enrollment ID | O20230316002858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518666700 | NPI | - | NPPES |
| 470718409 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Richey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366797235 PECOS PAC ID: 4385041094 Enrollment ID: I20210923000269 |
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