<Unavail>
LBN: Pine Lake Behavioral Health, Llc.
<Unavail> is an health care organization with primary practice located at 9100 Andermatt Drive Suite 1 , Lincoln NE 68526-0000. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Suppliers / Pharmacy. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty.
Pine Lake Behavioral Health, Llc. can be contacted via phone (402) 434-2730, or through Ray, Jared Wade via phone (402) 434-2730.
Contact Information
Primary practice address
9100 Andermatt Drive Suite 1
Lincoln NE 68526-0000
Phone: (402) 434-2730
Fax: (402) 434-3970
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | Nebraska | |
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | ||
| Suppliers / Pharmacy | 333600000X |
Profile Details
| NPI number | 1003310061 |
|---|---|
| LBN Legal business name | Pine Lake Behavioral Health, Llc. |
| DBA Doing business as | <Unavail> |
| Authorized official | Ray, Jared Wade LIPC, LADC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 22nd, 2018 |
| Last updated | Feb 24th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003310061 | NPPES |
| Nebraska | MEDICAID | 10026721200 | |
| Nebraska | Other | NA3283 | |
| Nebraska | MEDICAID | 10026721201 | |
| Nebraska | Other | DY5949 |
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