Healthcare Provider Details

I. General information

NPI: 1083572036
Provider Name (Legal Business Name): WHOLE WAY WELL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11207 W DODGE RD STE 250
OMAHA NE
68154-2650
US

IV. Provider business mailing address

11207 W DODGE RD STE 250
OMAHA NE
68154-2650
US

V. Phone/Fax

Practice location:
  • Phone: 402-913-0537
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA LAWRENCE
Title or Position: OWNER, THERAPIST
Credential: PLMHP
Phone: 402-913-0537