Organization
FALLBROOK BEHAVIORAL HEALTH, PC
Active
Organization
FALLBROOK BEHAVIORAL HEALTH, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J TIEGS PHD (PRESIDENT)
(402) 875-0632
Entity
Organization
Contact information
Practice address
755 FALLBROOK BLVD, STE 100, LINCOLN, NE 68521-4637
(402) 875-0632
(402) 438-2107
Mailing address
755 FALLBROOK BLVD, STE 100, LINCOLN, NE 68521-4637
(402) 875-0632
(402) 438-2107
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
747
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025914900
—
NE
Enumeration date
02/15/2012
Last updated
02/15/2012
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