| Prairie Oaks Trauma Care Center | |
|
11329 P St Suite 108 Omaha NE 68137-2315 | |
| (402) 650-1101 | |
| (402) 597-2122 |
| Full Name | Prairie Oaks Trauma Care Center |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11329 P St, Omaha, Nebraska |
| Authorized Official Name and Position | Alan Luis Hensley (CEO) |
| Authorized Official Contact | 4026501101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Oaks Trauma Care Center Po Box 44 Mineola IA 51554-0044 Ph: (402) 650-1101 | Prairie Oaks Trauma Care Center 11329 P St Suite 108 Omaha NE 68137-2315 Ph: (402) 650-1101 |
| NPI Number | 1164702106 |
|---|---|
| Provider Enumeration Date | 08/22/2011 |
| Last Update Date | 08/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164702106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3925 (Nebraska) | Secondary |
| 101YP2500X | Counselor - Professional | 1945 (Nebraska) | Primary |
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