Provider Demographics
NPI: | 1114440062 |
---|---|
Name: | THINK AKSARBEN, LLC |
Entity type: | Organization |
Organization Name: | THINK AKSARBEN, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | CANEDY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 402-506-9000 |
Mailing Address - Street 1: | 7100 W CENTER RD |
Mailing Address - Street 2: | |
Mailing Address - City: | OMAHA |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68106-2714 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 402-506-9000 |
Mailing Address - Fax: | 402-506-9093 |
Practice Address - Street 1: | 7100 W CENTER RD |
Practice Address - Street 2: | |
Practice Address - City: | OMAHA |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68106-2714 |
Practice Address - Country: | US |
Practice Address - Phone: | 402-506-9000 |
Practice Address - Fax: | 402-506-9093 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THINK NEBRASKA, LLC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2017-07-24 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |