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1941 S 42nd St Omaha NE 68105-2939 | |
| (402) 460-7963 | |
| (402) 763-2894 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1941 S 42nd St, Omaha, Nebraska |
| Authorized Official Name and Position | Odalys Cartaya Perez (LIMHP) |
| Authorized Official Contact | 4024607963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1941 S. 42nd St. 416-n Omaha NE 68105-2939 Ph: (402) 460-7963 | 1941 S 42nd St Omaha NE 68105-2939 Ph: (402) 460-7963 |
| NPI Number | 1255856696 |
|---|---|
| Provider Enumeration Date | 08/07/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255856696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1096 (Nebraska) | Primary |
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