Healthcare Provider Details

I. General information

NPI: 1184542649
Provider Name (Legal Business Name): PRECIOUS COMMUNITY BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N 31ST AVE STE 209
OMAHA NE
68131-2915
US

IV. Provider business mailing address

105 N 31ST AVE STE 209
OMAHA NE
68131-2915
US

V. Phone/Fax

Practice location:
  • Phone: 402-378-8505
  • Fax: 402-939-0676
Mailing address:
  • Phone: 402-378-8505
  • Fax: 402-939-0676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHARLENE WILSON
Title or Position: OWNER
Credential:
Phone: 402-378-8508