Organization
WILDFLOWER COLLECTIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA WISNESKI (ADMINISTRATIVE ASSISTANT)
(402) 205-5120
Entity
Organization
Contact information
Practice address
5824 S 142ND ST STE A, OMAHA, NE 68137-2872
(402) 205-5120
Mailing address
2809 S 160TH ST STE 101, OMAHA, NE 68130-1755
(402) 205-5120
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50727896000
—
NE
Enumeration date
07/27/2022
Last updated
11/12/2025
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