Healthcare Provider Details

I. General information

NPI: 1386885192
Provider Name (Legal Business Name): VEST PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 EUCLID ST
ASHLAND NE
68003-1214
US

IV. Provider business mailing address

1829 EUCLID ST
ASHLAND NE
68003-1214
US

V. Phone/Fax

Practice location:
  • Phone: 402-616-4439
  • Fax: 888-237-1288
Mailing address:
  • Phone: 402-616-4439
  • Fax: 888-237-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number110505
License Number StateNE

VIII. Authorized Official

Name: MRS. TINA M VEST
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: APRN
Phone: 402-616-4439