Provider Demographics
NPI:1679018030
Name:BUOYANT FAMILY SERVICES COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:BUOYANT FAMILY SERVICES COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLA
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-905-1120
Mailing Address - Street 1:THE CENTER 1941 SOUTH 42ND STREET
Mailing Address - Street 2:SUITE 416 S
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105
Mailing Address - Country:US
Mailing Address - Phone:402-905-1120
Mailing Address - Fax:
Practice Address - Street 1:THE CENTER 1941 SOUTH 42ND STREET
Practice Address - Street 2:SUITE 416 S
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105
Practice Address - Country:US
Practice Address - Phone:402-905-1120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1435251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health