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1932749868
BART SULLIVAN
OMAHA, NE
NPI
1932749868
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NE 876)
Enumeration Date
2020-01-08
Last Update Date
2020-01-08
Business Address
BART SULLIVAN
1502 N 58TH ST
OMAHA, NE 68104-4820
Phone number: 402-556-6425
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Mailing Address
BART SULLIVAN
1502 N 58TH ST
OMAHA, NE 68104-4820
Phone number: 402-556-6425
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