Healthcare Provider Details

I. General information

NPI: 1447166244
Provider Name (Legal Business Name): DANDELION GROVE BEHAVIORAL HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11515 S 39TH ST STE 302
BELLEVUE NE
68123-5214
US

IV. Provider business mailing address

11515 S 39TH ST STE 302
BELLEVUE NE
68123-5214
US

V. Phone/Fax

Practice location:
  • Phone: 712-355-2572
  • Fax:
Mailing address:
  • Phone: 712-355-2572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ALISON LAUREN CONDON
Title or Position: THERAPIST
Credential: LIMHP, LADC
Phone: 712-355-2572