NPI 1003310061

Pine Lake Behavioral Health, LLC.

Organisation Clinic/Center Lincoln, NE

Practice location

Address: 9100 Andermatt Drive Suite 1, Lincoln, NE 68526-0000
Phone: (402) 434-2730
Fax: (402) 434-3970
Mailing address: 9100 Andermatt Dr STE 1, Lincoln, NE 68526-6700

Authorised official

Name: Jared Wade Ray
Title: Director of Operations
Phone: (402) 434-2730

Registered specialties (3)

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X

Other Clinic/Center providers in Nebraska →

Mental Health Clinic/Center (Including Community Mental Health Center)

Ambulatory Health Care Facilities Taxonomy 261QM0801X

Pharmacy

Suppliers Taxonomy 333600000X

Other Pharmacy providers in Nebraska →

Registry record

NPI: 1003310061
Entity type: Organization
NPI issued: 22 Mar 2018
Record last updated: 24 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.