Provider Demographics
NPI:1558506212
Name:CARTER RELATIONSHIP DEVELOPMENT & COUNSELING CENTER
Entity Type:Organization
Organization Name:CARTER RELATIONSHIP DEVELOPMENT & COUNSELING CENTER
Other - Org Name:CARTER COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-502-1716
Mailing Address - Street 1:8031 W CENTER RD STE 206
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3134
Mailing Address - Country:US
Mailing Address - Phone:402-502-1716
Mailing Address - Fax:402-502-2513
Practice Address - Street 1:8031 W. CENTER RD.
Practice Address - Street 2:STE 206
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3134
Practice Address - Country:US
Practice Address - Phone:402-502-1716
Practice Address - Fax:402-502-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025700100Medicaid