1528221942 NPI number — DEVELOPMENTAL SERVICES OF NEBRASKA INC

Table of content: (NPI 1528221942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528221942 NPI number — DEVELOPMENTAL SERVICES OF NEBRASKA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEVELOPMENTAL SERVICES OF NEBRASKA 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:
DSN KC
Provider Other Organization Name Type Code:
5
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:
1528221942
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5701 THOMPSON CREEK BLVD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68516-5600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-435-2134
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5701 THOMPSON CREEK BLVD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68516-5600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-435-2134
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/07/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KANTER
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHEIF DEVELOPMENT OFFICER
Authorized Official Telephone Number:
402-435-2134

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  348216000 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 856344205 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100251801-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100251107-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".