Provider Demographics
NPI:1659608446
Name:MUSSMANN ENTERPRISES INC.
Entity Type:Organization
Organization Name:MUSSMANN ENTERPRISES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:JEREMEY
Authorized Official - Last Name:MUSSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-525-7466
Mailing Address - Street 1:1017 N 33RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1450
Mailing Address - Country:US
Mailing Address - Phone:402-525-7466
Mailing Address - Fax:402-558-3039
Practice Address - Street 1:4535 LEAVENWORTH ST STE 4
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-1453
Practice Address - Country:US
Practice Address - Phone:402-525-7466
Practice Address - Fax:402-558-3039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty