Provider Demographics
NPI:1457006157
Name:METRO INTEGRATIVE PSYCHIATRIC CARE PC
Entity Type:Organization
Organization Name:METRO INTEGRATIVE PSYCHIATRIC CARE PC
Other - Org Name:THRIVE COLLABORATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:402-689-4320
Mailing Address - Street 1:11717 BURT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-1500
Mailing Address - Country:US
Mailing Address - Phone:402-302-2775
Mailing Address - Fax:833-471-4570
Practice Address - Street 1:11717 BURT ST STE 203
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-1500
Practice Address - Country:US
Practice Address - Phone:402-302-2775
Practice Address - Fax:833-471-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2023-05-31
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