Provider Demographics
NPI:1831707868
Name:ALEXANDRIA REZNICEK MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ALEXANDRIA REZNICEK MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REZNICEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:402-261-6212
Mailing Address - Street 1:5539 S 27TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-1600
Mailing Address - Country:US
Mailing Address - Phone:402-261-6212
Mailing Address - Fax:
Practice Address - Street 1:5539 S 27TH ST STE 101
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-1600
Practice Address - Country:US
Practice Address - Phone:402-261-6212
Practice Address - Fax:402-817-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)