| Malcom Behavioral Health Services Llc | |
|
2315 W 39th St Ste 106 Kearney NE 68845-8327 | |
| (308) 233-3847 | |
| (308) 233-5921 |
| Full Name | Malcom Behavioral Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2315 W 39th St Ste 106, Kearney, Nebraska |
| Authorized Official Name and Position | Sarah L Gierhan (OWNER) |
| Authorized Official Contact | 3082333847 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Malcom Behavioral Health Services Llc 2315 W 39th St Ste 106 Kearney NE 68845-8327 Ph: (308) 233-3847 | Malcom Behavioral Health Services Llc 2315 W 39th St Ste 106 Kearney NE 68845-8327 Ph: (308) 233-3847 |
| NPI Number | 1184963126 |
|---|---|
| Provider Enumeration Date | 02/12/2013 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/03/2023 |
| Medicare PECOS PAC ID | 5395984371 |
|---|---|
| Medicare Enrollment ID | O20130624000455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184963126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Clint P Malcom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689620650 PECOS PAC ID: 3678573219 Enrollment ID: I20070105000201 |
| Provider Name | Sarah L Gierhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790224996 PECOS PAC ID: 7315287877 Enrollment ID: I20190319002718 |
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