MEDICARE: CHRIS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730321753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIS SERVICES

Provider Business Mailing Address
First Line	:	5222 N 24TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68110-1360
Country	:	US
Telephone Number	:	402-502-8077
Fax Number	:	402-502-8079

Provider Business Practice Location Address
First Line	:	5222 N 24TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68110-1360
Country	:	US
Telephone Number	:	402-502-8077
Fax Number	:	402-502-8079

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DINAH F TURRENTINE-SIMS
Credential	:
Telephone Number	:	402-502-8077

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	06/30/2009

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Directions to “CHRIS SERVICES ” Practice Location

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