Organization
OLD MILL COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID REHOV SKY M.S.MANAGER (MANAGER)
(308) 382-4495
Entity
Organization
Contact information
Practice address
712 W KOENIG ST, GRAND ISLAND, NE 68801-6556
(308) 382-4495
(308) 385-0407
Mailing address
712 W KOENIG ST, GRAND ISLAND, NE 68801-6556
(308) 382-4495
(308) 385-0407
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1001
NE
251S00000X
Community/Behavioral Health Agency
1330
NE
251S00000X
Community/Behavioral Health Agency
9115
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10055871100
—
NE
Enumeration date
08/30/2010
Last updated
08/30/2010
Update your record
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