Organization
ALIVATION HEALTH, LLC
Active
Other names
Premier Psychiatric Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER J. DUFFY M.D. (OWNER/CEO)
(402) 476-6060
Entity
Organization
Contact information
Practice address
8550 CUTHILLS CIRCLE, LINCOLN, NE 68526-9467
(402) 476-6060
(402) 476-6809
Mailing address
8550 CUTHILLS CIRCLE, LINCOLN, NE 68526-9467
(402) 476-6060
(402) 476-6809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098936
PTAN
NE
05
—
10025071300
—
NE
Enumeration date
07/05/2006
Last updated
07/21/2022
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