Pine Lake Behavioral Health, LLC.
NPI 1003310061ActiveOrganization· Clinic/Center· Lincoln, NE
Clinic/Center in Lincoln, Nebraska, registered in NPPES in March 2018. The authorized official on file is Jared Wade Ray, LIPC, LADC, Director Of Operations. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003310061 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 22, 2018 |
| Last updated in NPPES | Feb 24, 2020 |
| Certified by provider | Feb 24, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | — | NE |
| Clinic/Center, Mental Health (Including Community Mental Health Center) | 261QM0801X | — | — |
| Pharmacy | 333600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NE) |
|---|
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