Healthcare Provider Details
I. General information
NPI: 1740960723
Provider Name (Legal Business Name): MIDWEST DISABILITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
827 CALAIS ST
BELLEVUE NE
68123-3636
US
IV. Provider business mailing address
9507 Q ST
OMAHA NE
68127-5201
US
V. Phone/Fax
- Phone: 402-957-5902
- Fax:
- Phone: 402-957-5902
- Fax: 531-999-2797
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
AMBER
RAE
CROW
Title or Position: CEO
Credential:
Phone: 402-957-5902