NPI 1104939487 · live from the CMS NPI Registry
Alegent Health Immanuel Medical Center
Psychiatry & Neurology, Psychiatry in Omaha, NE. National Provider Identifier 1104939487, active.
NPI record
| NPI | 1104939487 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Psychiatry 2084P0800X |
| Practice location | 6901 N 72nd St, Omaha, NE 68122 |
| Practice phone | 402-572-2916 |
| Mailing address | 12809 W Dodge Rd, Omaha, NE 68154 |
| Enumerated | August 17, 2006 |
| Last updated | February 10, 2016 |
| Authorized official | Jeanette Wojtalewicz, Cfo |
| Other names | Chi Health Psychiatric Associates |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Psychiatry & Neurology, Psychiatry primary | 2084P0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.