Healthcare Provider Details

I. General information

NPI: 1811362726
Provider Name (Legal Business Name): SOZO FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 13TH ST STE 110
AURORA NE
68818-2426
US

IV. Provider business mailing address

616 13TH ST STE 110
AURORA NE
68818-2426
US

V. Phone/Fax

Practice location:
  • Phone: 402-631-7267
  • Fax: 402-694-4199
Mailing address:
  • Phone: 402-631-7267
  • Fax: 402-694-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNE

VIII. Authorized Official

Name: THERESA ARNETT NICKOLAUS
Title or Position: EXECUTIVE DIRECTOR
Credential: LIMHP, PLADC
Phone: 402-631-7267