Organization
FIRESIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARYNNE HORTON LP (PSYCHOLOGIST)
(785) 580-3937
Entity
Organization
Contact information
Practice address
1011 N 9TH ST, BEATRICE, NE 68310-2356
(785) 580-3937
Mailing address
1011 N 9TH ST, BEATRICE, NE 68310-2356
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025287200
—
NE
Enumeration date
02/08/2023
Last updated
02/08/2023
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