Provider Demographics
| NPI: | 1114440062 |
|---|---|
| Name: | THINK AKSARBEN, LLC |
| Entity type: | Organization |
| Organization Name: | THINK AKSARBEN, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | T |
| Authorized Official - Last Name: | CANEDY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 402-506-9000 |
| Mailing Address - Street 1: | 7100 W CENTER RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | OMAHA |
| Mailing Address - State: | NE |
| Mailing Address - Zip Code: | 68106-2714 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 402-506-9000 |
| Mailing Address - Fax: | 402-506-9093 |
| Practice Address - Street 1: | 7100 W CENTER RD |
| Practice Address - Street 2: | |
| Practice Address - City: | OMAHA |
| Practice Address - State: | NE |
| Practice Address - Zip Code: | 68106-2714 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 402-506-9000 |
| Practice Address - Fax: | 402-506-9093 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | THINK NEBRASKA, LLC |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2017-07-24 |
| Last Update Date: | 2022-07-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |