Provider Demographics
NPI:1649691783
Name:RELIABLE ROCK
Entity type:Organization
Organization Name:RELIABLE ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUROCK
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:402-214-6949
Mailing Address - Street 1:105 N 31ST AVE
Mailing Address - Street 2:212
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2940
Mailing Address - Country:US
Mailing Address - Phone:402-214-6949
Mailing Address - Fax:866-295-7627
Practice Address - Street 1:105 N 31ST AVE
Practice Address - Street 2:212
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2940
Practice Address - Country:US
Practice Address - Phone:402-214-6949
Practice Address - Fax:866-295-7627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9923251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health