Organization
P & P FABRICATION
Active
Other names
A Brand New Day
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ROBERT PORTER LADC (THERAPIST)
(402) 727-7278
Entity
Organization
Contact information
Practice address
92 W 5TH ST, STE B, FREMONT, NE 68025
(402) 727-7278
(402) 727-7366
Mailing address
92 W 5TH ST, STE B, FREMONT, NE 68025
(402) 727-7278
(402) 727-7366
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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