Organization
ANTLERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN RALPH FOX MA EDPYSCH LMHP LAPC (PRESIDENT)
(402) 434-3965
Entity
Organization
Contact information
Practice address
2501 SOUTH STREET, LINCOLN, NE 68502-3050
(402) 434-3965
(402) 434-3972
Mailing address
2501 SOUTH STREET, LINCOLN, NE 68502-3050
(402) 434-3965
(402) 434-3972
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99043
BLUE CROSS BLUE SHIELD OF
—
Enumeration date
12/26/2006
Last updated
08/22/2020
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