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General NPI Number Information
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NPI Number | 1790596211
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Entity Type | Organization
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Legal Business Name | AISWARY THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 6911 VAN DORN ST STE 2
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City | LINCOLN
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State | NE
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Zip | 68506-6801
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Country | US
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Telephone | 402-673-6385
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Fax | 531-249-5886
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Provider Business Mailing Address
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Address Line | 6911 VAN DORN ST STE 2
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City | LINCOLN
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State | NE
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Zip | 68506-6801
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Country | US
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Telephone | 402-673-6385
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Fax | 531-249-5886
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Authorized Official
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Title or Position | OWNER/ MENTAL HEALTH PROVIDER
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Name | AISWARY GANAPATHY DEVENDRA RAJAN
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Credential |
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Telephone | 402-673-6385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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