Provider Demographics
NPI:1275143877
Name:NEW BRAIN FRONTIER LLC
Entity Type:Organization
Organization Name:NEW BRAIN FRONTIER LLC
Other - Org Name:NEW BRAIN FRONTIER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-853-0993
Mailing Address - Street 1:7441 O ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2468
Mailing Address - Country:US
Mailing Address - Phone:402-853-0993
Mailing Address - Fax:402-853-0197
Practice Address - Street 1:8101 O ST STE 120
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2647
Practice Address - Country:US
Practice Address - Phone:402-853-0993
Practice Address - Fax:402-853-0197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty