Individual
JEREMY PAT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18556 DREXEL ST, OMAHA, NE 68135-1785
(402) 709-6177
Mailing address
3245 S 126TH AVE, OMAHA, NE 68144-4105
(402) 709-6177
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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