Provider Demographics
NPI:1114502234
Name:UBU THERAPY FARMS, LLC
Entity Type:Organization
Organization Name:UBU THERAPY FARMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:402-833-8160
Mailing Address - Street 1:1620 W BURNHAM ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-9224
Mailing Address - Country:US
Mailing Address - Phone:402-833-8160
Mailing Address - Fax:
Practice Address - Street 1:1620 W BURNHAM ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-9224
Practice Address - Country:US
Practice Address - Phone:402-833-8160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty