| Prime Home Developmental Disabilities Services, Inc | |
|
6818 Grover St Ste 200 Omaha NE 68106-3632 | |
| (402) 932-0072 | |
| (402) 932-0072 |
| Full Name | Prime Home Developmental Disabilities Services, Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6818 Grover St Ste 200, Omaha, Nebraska |
| Authorized Official Name and Position | Rhonda Kathryn Bojanski (CFO) |
| Authorized Official Contact | 4029320072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Home Developmental Disabilities Services, Inc 6818 Grover St Ste 200 Omaha NE 68106-3632 Ph: (402) 932-0072 | Prime Home Developmental Disabilities Services, Inc 6818 Grover St Ste 200 Omaha NE 68106-3632 Ph: (402) 932-0072 |
| NPI Number | 1326536558 |
|---|---|
| Provider Enumeration Date | 04/24/2018 |
| Last Update Date | 04/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326536558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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