Full Name | |
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Speciality | Counselor - Mental Health |
Location | 203 Kendall St, Waco, Nebraska |
Authorized Official Name and Position | Mark Klug (CEO) |
Authorized Official Contact | 8886859522 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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W175n11120 Stonewood Dr Germantown WI 53022-6511 Ph: (800) 438-1772 | 203 Kendall St Waco NE 68460-3000 Ph: (800) 438-1772 |
NPI Number | 1538607080 |
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Provider Enumeration Date | 02/05/2017 |
Last Update Date | 02/05/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538607080 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 11017 (Nebraska) | Primary |