1861698110 NPI number — FAMILY SKILL BUILDING SERVICES

Table of content: (NPI 1861698110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861698110 NPI number — FAMILY SKILL BUILDING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY SKILL BUILDING SERVICES
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:
1861698110
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1300 E 4TH ST
Provider Second Line Business Mailing Address:
P.O. BOX 655
Provider Business Mailing Address City Name:
NORTH PLATTE
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
69101-4393
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-696-0033
Provider Business Mailing Address Fax Number:
308-696-0034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 E 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH PLATTE
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
69101-4393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-696-0033
Provider Business Practice Location Address Fax Number:
308-696-0034
Provider Enumeration Date:
06/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEONHARDT
Authorized Official First Name:
KENDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
308-696-0033

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  419 , 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