MEDICARE: KENNETH R DOWNING LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1659382745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNETH R DOWNING LLC

Provider Business Mailing Address
First Line	:	701 P ST
Second Line	:	STE. 305
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-420-6621
Fax Number	:	402-420-6680

Provider Business Practice Location Address
First Line	:	701 P ST
Second Line	:	STE 305
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-420-6621
Fax Number	:	402-420-6680

Authorized Official
Title or Position	:	OWNER PROVIDER
Name	:	KENNETH R DOWNING
Credential	:	PH.D.
Telephone Number	:	402-420-6621

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	10/01/2007

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