Organization Name: | ABBA LIGHTED PATH RECOVERY SERVICES |
NPI Number: | 1073941100 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY REMINGTON (PROVIDER) |
Mailing Address: | 905 Main St Seward |
State: | NE US |
Postal Code: | 684342047 |
Phone Number: | 4026416245 |
Fax Number: | |
NPI Enumeration Date: | 10/29/2013 |
NPI Last Update Date: | 10/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |