MEDICARE: RODNEY DELL LADC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	902	NE

General Provider Information

NPI Number	:	1538603188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY DELL LADC

Provider Business Mailing Address
First Line	:	835 S BURLINGTON AVE STE 115
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-6928
Country	:	US
Telephone Number	:	402-462-2066
Fax Number	:	402-462-2045

Provider Business Practice Location Address
First Line	:	835 S BURLINGTON AVE STE 115
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-6928
Country	:	US
Telephone Number	:	402-462-2066
Fax Number	:	402-462-2045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2016
Last Update Date	:	12/15/2016

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Directions to “ RODNEY DELL LADC” Practice Location

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