| Rainwood Healing Space- Llc | |
|
9910 N 48th St Ste 111 Omaha NE 68152-1548 | |
| (402) 813-8244 | |
| Not Available |
| Full Name | Rainwood Healing Space- Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 9910 N 48th St Ste 111, Omaha, Nebraska |
| Authorized Official Name and Position | Tonya Marie Goodwin-daly (OWNER/OPERATOR) |
| Authorized Official Contact | 4028138244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainwood Healing Space- Llc 9910 N 48th St Ste 111 Omaha NE 68152-1548 Ph: (402) 813-8244 | Rainwood Healing Space- Llc 9910 N 48th St Ste 111 Omaha NE 68152-1548 Ph: (402) 813-8244 |
| NPI Number | 1235776147 |
|---|---|
| Provider Enumeration Date | 12/10/2019 |
| Last Update Date | 12/10/2019 |
| Certification Date | 12/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235776147 | NPI | - | NPPES |
| 1437640760 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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