Provider Demographics
NPI:1477373454
Name:FLOREZ MENTAL HEALTH
Entity type:Organization
Organization Name:FLOREZ MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARNELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:308-224-1053
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-0164
Mailing Address - Country:US
Mailing Address - Phone:308-270-0368
Mailing Address - Fax:308-270-0080
Practice Address - Street 1:204 E 25TH ST STE 6
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4569
Practice Address - Country:US
Practice Address - Phone:308-270-0368
Practice Address - Fax:308-270-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty