| Saraann Staley Llc | |
|
268 N 115th St Ste 1 Omaha NE 68154-2502 | |
| (402) 403-9469 | |
| Not Available |
| Full Name | Saraann Staley Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 268 N 115th St Ste 1, Omaha, Nebraska |
| Authorized Official Name and Position | Saraann Staley (OWNER) |
| Authorized Official Contact | 4024039469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saraann Staley Llc 11026 Spring St Omaha NE 68144-4838 Ph: (402) 680-9158 | Saraann Staley Llc 268 N 115th St Ste 1 Omaha NE 68154-2502 Ph: (402) 403-9469 |
| NPI Number | 1053970996 |
|---|---|
| Provider Enumeration Date | 06/12/2019 |
| Last Update Date | 06/12/2019 |
| Medicare PECOS PAC ID | 8921495623 |
|---|---|
| Medicare Enrollment ID | O20220427002830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053970996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Saraann Staley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790137842 PECOS PAC ID: 0446672778 Enrollment ID: I20200615002968 |
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