| NPI | 1003310061 |
|---|---|
| Doing Business As | PINE LAKE BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | JARED WADE RAY Director Of Operations 402-434-2730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 333600000X Pharmacy | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2020-02-24 |