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NPI Code Detail

MEDICARE: LORENA RIVAS

MEDICARE: LORENA RIVAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1023843828
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORENA RIVAS
Provider Business Mailing Address
First Line : 1203 S 8TH ST
Second Line :
City : NORFOLK
State : NE
Zip : 68701-5875
Country : US
Telephone Number : 402-371-0220
Fax Number :
Provider Business Practice Location Address
First Line : 2718 13TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4917
Country : US
Telephone Number : 402-371-0220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2024
Last Update Date : 12/03/2024

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Directions to “ LORENA RIVAS ” Practice Location

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