Organization
THE WELL NE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONIELLE LARSON (EXECUTIVE DIRECTOR)
(402) 371-0220
Entity
Organization
Contact information
Practice address
910 W PARK AVE, NORFOLK, NE 68701-5044
(402) 379-3622
(402) 644-4593
Mailing address
PO BOX 1392, NORFOLK, NE 68702-1392
(402) 844-4710
(402) 371-7932
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
SATC068
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252183-00
—
NE
Enumeration date
12/18/2006
Last updated
09/12/2024
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