Organization
PONCA TRIBE OF NEBRASKA
Active
Other names
Fred LeRoy Health and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DONALD LEE CEO (CHIEF EXECUTIVE OFFICER)
(402) 734-5275
Entity
Organization
Contact information
Practice address
2602 J ST, OMAHA, NE 68107-1643
(402) 734-5275
(402) 733-3487
Mailing address
2602 J ST, OMAHA, NE 68107-1643
(402) 734-5275
(402) 733-3487
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
SATC157
NE
251S00000X
Community/Behavioral Health Agency
SATC173
NE
251S00000X
Community/Behavioral Health Agency
Primary
SATC174
NE
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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