MEDICARE: OLLIE WEBB CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	261Q00000X	Clinic/Center
3	261QD1600X	Developmental Disabilities Clinic/Center
4	261QM0850X	Adult Mental Health Clinic/Center
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437629755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLLIE WEBB CENTER, INC.

Provider Business Mailing Address
First Line	:	1941 S 42ND ST STE 122
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2942
Country	:	US
Telephone Number	:	402-342-4418
Fax Number	:	402-342-4857

Provider Business Practice Location Address
First Line	:	1941 S 42ND ST STE 122
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68105-2942
Country	:	US
Telephone Number	:	402-342-4418
Fax Number	:	402-342-4857

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LAURIE ACKERMANN
Credential	:
Telephone Number	:	402-334-6522

Provider Enumeration Date	:	11/29/2018
Last Update Date	:	11/29/2018

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Directions to “OLLIE WEBB CENTER, INC. ” Practice Location

Language	Start Address	Practice Location

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