| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2602 J St, Omaha, Nebraska |
| Authorized Official Name and Position | Donald Lee (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4027345275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2602 J St Omaha NE 68107-1643 Ph: (402) 734-5275 | 2602 J St Omaha NE 68107-1643 Ph: (402) 734-5275 |
| NPI Number | 1295058733 |
|---|---|
| Provider Enumeration Date | 03/11/2010 |
| Last Update Date | 03/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295058733 | NPI | - | NPPES |
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