FAMILY LIFE CLINIC


Address: 207 East 6th, Lexington, NE 68850
Phone: 3083245623

FAMILY LIFE CLINIC (NPI# 1174691935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174691935
Entity Type Organization
Organization Name FAMILY LIFE CLINIC
Other Organization Name WANDA L ENNS
Practice Address 207 East 6th
Lexington
NE 68850
Mailing Address 207 East 6th
Po Box 714
Lexington
NE 68850
Practice Telephone 3083245623
Practice Fax Number 3083245624
Mailing Telephone 3083245623
Mailing Fax Number 3083245624
Enumeration Date 2006-12-01
Last Update Date 2008-06-18
Authorized Official Name MRS. WANDA L ENNS (OWNER)
Authorized Official Telephone 3082365006
Authorized Official Credential PHD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 106H00000X Marriage & Family Therapist 72 NE Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
1071 NE Behavioral Health & Social Service Providers

Other Provider/Organization Names

Other Name Type Code
Wanda L Enns Doing Business As Name - Organization

Office Location

Street Address 207 EAST 6TH
City LEXINGTON
State NE
Zip Code 68850

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1942422514 Danette Anderson Occupational Therapist 110 West 5th Street, Family Physical Therapy & Sports Center, PC, Lexington, NE 68850 2007-05-03
1730206384 Wanda L Enns Psychologist 207 East 6th Street, Suite 4, Lexington, NE 68850 2007-03-26
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1508936444 Jerrold A Remmenga Dentist 903 N. Grant, Lexington, NE 68850 2006-11-08
1043397599 Larry Dean Moomey Optometrist 801 No Grant, Lexington, NE 68850 2006-11-01
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City LEXINGTON
Zip Code 68850

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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