| Chain Breaker, Llc | |
|
1941 S 42nd St Ste 402d Omaha NE 68105-2944 | |
| (402) 237-7482 | |
| Not Available |
| Full Name | Chain Breaker, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1941 S 42nd St Ste 402d, Omaha, Nebraska |
| Authorized Official Name and Position | Cynthia Kay Goodrich (SUBSTANCE ABUSE COUNSELOR) |
| Authorized Official Contact | 4022377482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chain Breaker, Llc 2410 S 48th Ave Omaha NE 68106-3225 Ph: (402) 237-7482 | Chain Breaker, Llc 1941 S 42nd St Ste 402d Omaha NE 68105-2944 Ph: (402) 237-7482 |
| NPI Number | 1073189908 |
|---|---|
| Provider Enumeration Date | 06/01/2021 |
| Last Update Date | 06/01/2021 |
| Certification Date | 06/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073189908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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