Organization
SPECIALIZED OUTPATIENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA L KISSACK LIMHP (MENTAL HEALTH PRACTIONER)
(308) 379-8619
Entity
Organization
Contact information
Practice address
1811 WEST 2ND STREET SUITE 450, GRAND ISLAND, NE 68803
(308) 379-8619
(308) 384-0194
Mailing address
1811 WEST 2ND STREET SUITE 450, GRAND ISLAND, NE 68803
(308) 379-8619
(308) 384-0194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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