| Gb12, Llc | |
|
380 Broadway St Tecumseh NE 68450-2454 | |
| (402) 310-0854 | |
| Not Available |
| Full Name | Gb12, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 380 Broadway St, Tecumseh, Nebraska |
| Authorized Official Name and Position | Galen D Bernadt (CEO) |
| Authorized Official Contact | 4023100854 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gb12, Llc 380 Broadway St Tecumseh NE 68450-2454 Ph: (402) 310-0854 | Gb12, Llc 380 Broadway St Tecumseh NE 68450-2454 Ph: (402) 310-0854 |
| NPI Number | 1306679147 |
|---|---|
| Provider Enumeration Date | 08/26/2024 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306679147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Johnson County Public Schools Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 358 N 6th St, Tecumseh, NE 68450 Phone: 402-335-3320 |