Organization · Type 2 NPI

Pine Lake Behavioral Health, Llc.

Clinic/Center · Lincoln, NE

NPI number 1003310061 Active

Practice location

9100 Andermatt Drive Suite 1
Lincoln, NE 68526-0000

Call (402) 434-2730 Map

Fax (402) 434-3970

Mailing address

9100 Andermatt Dr Ste 1
Lincoln, NE 68526-6700

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Pharmacy	333600000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

4 other providers at this address

Other clinic/center providers in Lincoln

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NPI record

NPI: 1003310061
Entity type: Organization (Type 2)
Issued: Mar 22, 2018
Last updated: Feb 24, 2020
Status: Active

Other names

<unavail>
Pine Lake Behavioral Health · doing business as
Pine Lake Behavioral Health · doing business as

Authorized official

Jared Wade Ray, LIPC, LADC
Director of Operations
(402) 434-2730

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003310061

Pine Lake Behavioral Health, Llc.'s National Provider Identifier is 1003310061, issued on Mar 22, 2018. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Lincoln, NE. The record was last updated on Feb 24, 2020.