Provider Demographics
NPI:1114484334
Name:VERVE COLLABORATIVE HEALTH LLC
Entity Type:Organization
Organization Name:VERVE COLLABORATIVE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS AND TECHNOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-898-1113
Mailing Address - Street 1:11404 W DODGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2511
Mailing Address - Country:US
Mailing Address - Phone:402-898-1113
Mailing Address - Fax:
Practice Address - Street 1:11404 W DODGE RD STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2511
Practice Address - Country:US
Practice Address - Phone:402-898-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-24
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026775500Medicaid