Organization
LLB LASER LLC
Active
Parent organization
PRIDE HEALTH CLINIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIDE HEALTH CLINIC LLC
Authorized official
LESLIE DVORK APRN (OWNER)
(402) 243-1526
Entity
Organization
Contact information
Practice address
4905 S 107TH AVE STE 200, OMAHA, NE 68127-1940
(402) 243-1526
Mailing address
4905 S 107TH AVE STE 200, OMAHA, NE 68127-1940
(402) 243-1526
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
02/12/2025
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