Provider Demographics
NPI:1568191849
Name:BEAR COMPANY LLC
Entity Type:Organization
Organization Name:BEAR COMPANY LLC
Other - Org Name:BEAR COMPANY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAYTON
Authorized Official - Middle Name:JIBRI
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-819-9712
Mailing Address - Street 1:5858 WENNINGHOFF RD STE 2
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1911
Mailing Address - Country:US
Mailing Address - Phone:402-512-3475
Mailing Address - Fax:402-206-2759
Practice Address - Street 1:5858 WENNINGHOFF RD STE 2
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-1911
Practice Address - Country:US
Practice Address - Phone:402-512-3475
Practice Address - Fax:402-206-2759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10027143802Medicaid
NE10027143800Medicaid