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General NPI Number Information
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NPI Number | 1508275801
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Entity Type | Organization
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Legal Business Name | ENLIGHTEN BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 7615 NASHWAY RD
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City | LINCOLN
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State | NE
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Zip | 68516-3397
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Country | US
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Telephone | 402-440-1764
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Fax |
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Provider Business Mailing Address
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Address Line | 7615 NASHWAY RD
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City | LINCOLN
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State | NE
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Zip | 68516-3397
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Country | US
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Telephone | 402-440-1764
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | PATRICK LEE KREIFELS
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Credential | LCMSW
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Telephone | 402-440-1764
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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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