Provider Demographics
NPI:1790596211
Name:AISWARY THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:AISWARY THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MENTAL HEALTH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AISWARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GANAPATHY DEVENDRA RAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-673-6385
Mailing Address - Street 1:6911 VAN DORN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-6801
Mailing Address - Country:US
Mailing Address - Phone:402-673-6385
Mailing Address - Fax:531-249-5886
Practice Address - Street 1:6911 VAN DORN ST STE 2
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6801
Practice Address - Country:US
Practice Address - Phone:402-673-6385
Practice Address - Fax:531-249-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health