1154459121 NPI number — SANDHILLS CENTER FOR SERVICES INC

Table of content: (NPI 1154459121)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154459121 NPI number — SANDHILLS CENTER FOR SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SANDHILLS CENTER FOR SERVICES 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:
Provider Other Organization Name Type Code:
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:
1154459121
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1712 O ST
Provider Second Line Business Mailing Address:
PO BOX 113
Provider Business Mailing Address City Name:
ORD
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68862-1722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-728-7099
Provider Business Mailing Address Fax Number:
308-728-5688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1712 O ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORD
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68862-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-728-7099
Provider Business Practice Location Address Fax Number:
308-728-5688
Provider Enumeration Date:
03/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SITZ
Authorized Official First Name:
ELLEN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
OWNER OF SANDHILLS
Authorized Official Telephone Number:
308-728-7099

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  1035 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 548 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 8241 , 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)





Copyright © 2007-2025 www.npivalidator.com