| Root Of It Llc | |
|
11580 W Dodge Rd Omaha NE 68154-2537 | |
| (402) 238-1431 | |
| (402) 281-1862 |
| Full Name | Root Of It Llc |
|---|---|
| Speciality | Counselor |
| Location | 11580 W Dodge Rd, Omaha, Nebraska |
| Authorized Official Name and Position | Perry Root (OWNER) |
| Authorized Official Contact | 4022157327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Root Of It Llc 11580 W Dodge Rd Omaha NE 68154-2537 Ph: (402) 238-1431 | Root Of It Llc 11580 W Dodge Rd Omaha NE 68154-2537 Ph: (402) 238-1431 |
| NPI Number | 1124782016 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 3779972641 |
|---|---|
| Medicare Enrollment ID | O20211115001927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124782016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Perry James Root |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417415621 PECOS PAC ID: 7719396720 Enrollment ID: I20210504000777 |
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