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General NPI Number Information
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NPI Number | 1225808314
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Entity Type | Organization
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Legal Business Name | FRONTLINE COUNSELING LLC
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 1339 POJAQUE CT NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-5351
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Country | US
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Telephone | 505-417-5461
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Fax |
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Provider Business Mailing Address
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Address Line | 18717 HOWE ST
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City | OMAHA
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State | NE
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Zip | 68130-6000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GRETCHEN BJERKE
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Credential | MS
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Telephone | 505-417-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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