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707 W 1st St Grand Island NE 68801-5805 | |
| (308) 382-0422 | |
| (308) 382-6195 |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 707 W 1st St, Grand Island, Nebraska |
| Authorized Official Name and Position | Tara Lesiak (DIRECTOR OF HR/QI) |
| Authorized Official Contact | 3083820422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
707 W 1st St Grand Island NE 68801-5805 Ph: (308) 382-0422 | 707 W 1st St Grand Island NE 68801-5805 Ph: (308) 382-0422 |
| NPI Number | 1861926628 |
|---|---|
| Provider Enumeration Date | 04/18/2017 |
| Last Update Date | 04/18/2017 |
| Medicare PECOS PAC ID | 3971043167 |
|---|---|
| Medicare Enrollment ID | O20240914000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861926628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SATC005 (Nebraska) | Primary |
| Provider Name | Emily Feese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457819393 PECOS PAC ID: 8022556737 Enrollment ID: I20240813001951 |
| Provider Name | Adriana Arroyo-herrera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952850158 PECOS PAC ID: 2860735768 Enrollment ID: I20241022003129 |
| Provider Name | Tracee Lynn Franssen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891117883 PECOS PAC ID: 4587197348 Enrollment ID: I20241031002960 |
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