| Growth On The Plains, Llc | |
|
3710 Central Ave Ste 4 Kearney NE 68847-8126 | |
| (308) 233-1979 | |
| Not Available |
| Full Name | Growth On The Plains, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3710 Central Ave Ste 4, Kearney, Nebraska |
| Authorized Official Name and Position | Deidre Hollister (OWNER/THERAPIST) |
| Authorized Official Contact | 3082331979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Growth On The Plains, Llc 3710 Central Ave Ste 4 Kearney NE 68847-8126 Ph: () - | Growth On The Plains, Llc 3710 Central Ave Ste 4 Kearney NE 68847-8126 Ph: (308) 233-1979 |
| NPI Number | 1922719186 |
|---|---|
| Provider Enumeration Date | 12/08/2022 |
| Last Update Date | 07/31/2023 |
| Certification Date | 07/31/2023 |
| Medicare PECOS PAC ID | 5890168801 |
|---|---|
| Medicare Enrollment ID | O20230222000772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922719186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Deidre Lynne Hollister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811537376 PECOS PAC ID: 3274957279 Enrollment ID: I20200723001738 |
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