| Luminosity | |
|
301 Broadway St Concord NE 68728-2841 | |
| (402) 650-6214 | |
| Not Available |
| Full Name | Luminosity |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 301 Broadway St, Concord, Nebraska |
| Authorized Official Name and Position | Brenda Rae Surber (OWNER) |
| Authorized Official Contact | 4026506214 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminosity 301 Broadway St Concord NE 68728-2841 Ph: (402) 650-6214 | Luminosity 301 Broadway St Concord NE 68728-2841 Ph: (402) 650-6214 |
| NPI Number | 1720350333 |
|---|---|
| Provider Enumeration Date | 01/30/2012 |
| Last Update Date | 01/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720350333 | NPI | - | NPPES |
| 10025530800 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3071 (Nebraska) | Primary |