Provider Demographics
NPI:1508275801
Name:ENLIGHTEN BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:ENLIGHTEN BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KREIFELS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMSW
Authorized Official - Phone:402-440-1764
Mailing Address - Street 1:7615 NASHWAY RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3397
Mailing Address - Country:US
Mailing Address - Phone:402-440-1764
Mailing Address - Fax:
Practice Address - Street 1:7615 NASHWAY RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3397
Practice Address - Country:US
Practice Address - Phone:402-440-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health