Organization
PURE LIFE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DUNLAVY PLMHP (OWNER)
(402) 543-3392
Entity
Organization
Contact information
Practice address
11580 W DODGE RD, OMAHA, NE 68154-2537
(402) 238-1431
Mailing address
11580 W DODGE RD, OMAHA, NE 68154-2537
(402) 238-1431
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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