Organization
KEEN MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA HUMPHREY (ACCOUNT MANAGER)
(402) 504-4680
Entity
Organization
Contact information
Practice address
4905 S 107TH AVE, OMAHA, NE 68127-1965
(402) 819-1823
Mailing address
16101 GREBE ST, BENNINGTON, NE 68007-1255
(402) 517-0839
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
08/26/2022
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