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General NPI Number Information
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NPI Number | 1811780125
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Entity Type | Organization
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Legal Business Name | SOCIETY X LLC
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 11060 OAK ST STE 7
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City | OMAHA
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State | NE
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Zip | 68144-4244
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Country | US
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Telephone | 402-881-0795
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Fax |
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Provider Business Mailing Address
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Address Line | 16527 SPRING CIR
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City | OMAHA
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State | NE
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Zip | 68130-2039
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Country | US
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Telephone | 308-650-1187
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIANNA JOELLE TENHOFF
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Credential | APRN
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Telephone | 402-881-0795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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