Organization
LESLIE RICHARDSON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE RICHARDSON (OWNER)
(402) 470-7130
Entity
Organization
Contact information
Practice address
3201 PIONEERS BLVD, 112, LINCOLN, NE 68502-5963
(402) 486-3110
Mailing address
2820 JANE LN, LINCOLN, NE 68516-2746
(402) 470-7130
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1136
NE
251S00000X
Community/Behavioral Health Agency
147
NE
251S00000X
Community/Behavioral Health Agency
Primary
3827
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98402
BCBS
NE
Enumeration date
12/05/2016
Last updated
12/05/2016
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