Organization
HOLLIST TREATMENT FOR ADOLESCENTS AND FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY STONEWALL HOLLIST PH.D, LIMHP, LIMFT (PRESIDENT)
(402) 202-0506
Entity
Organization
Contact information
Practice address
2111 W MULBERRY ST, LINCOLN, NE 68522-1421
(402) 202-0577
(402) 438-5330
Mailing address
2111 W MULBERRY ST, LINCOLN, NE 68522-1421
(402) 202-0577
(402) 438-5330
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
272
NE
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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