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General NPI Number Information
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NPI Number | 1184542649
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Entity Type | Organization
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Legal Business Name | PRECIOUS COMMUNITY BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 105 N 31ST AVE STE 209
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City | OMAHA
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State | NE
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Zip | 68131-2915
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Country | US
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Telephone | 402-378-8505
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Fax | 402-939-0676
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Provider Business Mailing Address
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Address Line | 105 N 31ST AVE STE 209
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City | OMAHA
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State | NE
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Zip | 68131-2915
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Country | US
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Telephone | 402-378-8505
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Fax | 402-939-0676
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Authorized Official
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Title or Position | OWNER
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Name | CHARLENE WILSON
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Credential |
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Telephone | 402-378-8508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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