Provider Demographics
NPI:1982459749
Name:NYERI LLC
Entity Type:Organization
Organization Name:NYERI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GATERE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MPH, APRN
Authorized Official - Phone:660-528-1439
Mailing Address - Street 1:17659 WEBER ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-3346
Mailing Address - Country:US
Mailing Address - Phone:660-528-1439
Mailing Address - Fax:
Practice Address - Street 1:12020 SHAMROCK PLZ STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3537
Practice Address - Country:US
Practice Address - Phone:402-687-6665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health