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General NPI Number Information
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NPI Number | 1730004839
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Entity Type | Organization
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Legal Business Name | REJUVENATION CONNECTION, LLC
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 2421 BAUMAN AVE
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City | OMAHA
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State | NE
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Zip | 68112-3311
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Country | US
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Telephone | 402-637-5166
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Fax |
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Provider Business Mailing Address
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Address Line | 1023 JONES ST APT 902
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City | OMAHA
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State | NE
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Zip | 68102-2937
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Country | US
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Telephone | 402-637-5166
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Fax |
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Authorized Official
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Title or Position | PROGRAM CREATOR
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Name | FRANK LOUIS BAILEY III
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Credential | LADC, LMHP, LPC
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Telephone | 402-637-5166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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