Healthcare Provider Details

I. General information

NPI: 1295742385
Provider Name (Legal Business Name): DR BROZ AND ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 WEST 2ND STREET SUITE 280
GRAND ISLAND NE
68803-5445
US

IV. Provider business mailing address

1811 WEST 2ND STREET SUITE 280
GRAND ISLAND NE
68803-5445
US

V. Phone/Fax

Practice location:
  • Phone: 402-750-8712
  • Fax: 308-832-4401
Mailing address:
  • Phone: 402-750-8712
  • Fax: 308-832-4401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLIMHP1000
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1000
License Number StateNE

VIII. Authorized Official

Name: DR. SANDRA KAYE BROZ
Title or Position: OWNER
Credential: LIMHP
Phone: 402-750-8712