Provider Demographics
NPI:1194891499
Name:SAINT FRANCIS STUDENT WELLNESS CENTER
Entity type:Organization
Organization Name:SAINT FRANCIS STUDENT WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MH SA COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMELISE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:BAUGHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED LMHP LADC
Authorized Official - Phone:308-384-2265
Mailing Address - Street 1:2124 N LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2048
Mailing Address - Country:US
Mailing Address - Phone:308-384-2265
Mailing Address - Fax:308-384-2243
Practice Address - Street 1:2124 N LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2048
Practice Address - Country:US
Practice Address - Phone:308-384-2265
Practice Address - Fax:308-384-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2790261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health