1295742385 NPI number — DR BROZ AND ASSOCIATES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295742385 NPI number — DR BROZ AND ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR BROZ AND ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORFOLK COUNSELING SERVICES
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295742385
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1811 WEST 2ND STREET
Provider Second Line Business Mailing Address:
SUITE 280
Provider Business Mailing Address City Name:
GRAND ISLAND
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68803-5445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-750-8712
Provider Business Mailing Address Fax Number:
308-832-4401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1811 WEST 2ND STREET
Provider Second Line Business Practice Location Address:
SUITE 280
Provider Business Practice Location Address City Name:
GRAND ISLAND
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68803-5445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-750-8712
Provider Business Practice Location Address Fax Number:
308-832-4401
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BROZ
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
KAYE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
402-750-8712

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LIMHP1000 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251B00000X , with the licence number: 1000 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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