Organization
RAINWOOD HEALING SPACE- LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA MARIE GOODWIN-DALY BS,PLADC, MS (OWNER/OPERATOR)
(402) 813-8244
Entity
Organization
Contact information
Practice address
9910 N 48TH ST STE 111, OMAHA, NE 68152-1548
(402) 813-8244
Mailing address
9910 N 48TH ST STE 111, OMAHA, NE 68152-1548
(402) 813-8244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437640760
—
NE
Enumeration date
12/10/2019
Last updated
12/10/2019
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