Provider Demographics
NPI:1396024493
Name:ASSET OF NEBRASKA, INC.
Entity Type:Organization
Organization Name:ASSET OF NEBRASKA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARYLL
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-489-2218
Mailing Address - Street 1:3801 UNION DR STE 206
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6652
Mailing Address - Country:US
Mailing Address - Phone:402-489-2218
Mailing Address - Fax:402-489-3666
Practice Address - Street 1:3801 UNION DR STE 206
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6652
Practice Address - Country:US
Practice Address - Phone:402-489-2218
Practice Address - Fax:402-489-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty