| Ven Healthcare Council Bluffs Llc | |
|
29 S Main St Council Bluffs IA 51503-9070 | |
| (712) 524-1888 | |
| Not Available |
| Full Name | Ven Healthcare Council Bluffs Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 29 S Main St, Council Bluffs, Iowa |
| Authorized Official Name and Position | Vithyalakshmi Selvaraj (OWNER) |
| Authorized Official Contact | 7125241888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ven Healthcare Council Bluffs Llc 29 S Main St Council Bluffs IA 51503-9070 Ph: (712) 524-1888 | Ven Healthcare Council Bluffs Llc 29 S Main St Council Bluffs IA 51503-9070 Ph: (712) 524-1888 |
| NPI Number | 1306526116 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/18/2023 |
| Medicare PECOS PAC ID | 5496107955 |
|---|---|
| Medicare Enrollment ID | O20240119002762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306526116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Virginia J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568827095 PECOS PAC ID: 6103129184 Enrollment ID: I20171110001158 |
| Provider Name | Alfred Ongesa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013688530 PECOS PAC ID: 2163810151 Enrollment ID: I20211025000953 |
| Provider Name | Bridget Nore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306508262 PECOS PAC ID: 8426447988 Enrollment ID: I20211123000673 |
| Provider Name | Vithyalakshmi Selvaraj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801006325 PECOS PAC ID: 5698946531 Enrollment ID: I20240328001089 |
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