Organization
MELISSA ELLISON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ELLISON LIMHP (OWNER AND PROVIDER)
(402) 680-2699
Entity
Organization
Contact information
Practice address
18049 OAK ST STE B, OMAHA, NE 68130-6093
(402) 680-2699
Mailing address
18049 OAK ST STE B, OMAHA, NE 68130-6093
(402) 680-2699
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12769518
CAQH
NE
Enumeration date
07/31/2019
Last updated
09/13/2022
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