Provider Demographics
NPI:1023897634
Name:ECLIPSE QUANTUM WELLNESS LLC
Entity type:Organization
Organization Name:ECLIPSE QUANTUM WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BUSSING
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:531-222-4779
Mailing Address - Street 1:2111 S 67TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2882
Mailing Address - Country:US
Mailing Address - Phone:531-222-4779
Mailing Address - Fax:
Practice Address - Street 1:2111 S 67TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2882
Practice Address - Country:US
Practice Address - Phone:402-819-9603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty