Provider Demographics
NPI:1740998632
Name:TOPAZ MENTAL HEALTH LLC
Entity type:Organization
Organization Name:TOPAZ MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-220-0229
Mailing Address - Street 1:3206 S 71ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3507
Mailing Address - Country:US
Mailing Address - Phone:414-220-0229
Mailing Address - Fax:
Practice Address - Street 1:3206 S 71ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3507
Practice Address - Country:US
Practice Address - Phone:414-220-0229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty