Healthcare Provider Details

I. General information

NPI: 1437261211
Provider Name (Legal Business Name): COMMUNITY ACTION PARTNERSHIP OF WESTERN NEBRASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 CRESCENT DRIVE
GERING NE
69341-1724
US

IV. Provider business mailing address

3350 10TH STREET
GERING NE
69341-1712
US

V. Phone/Fax

Practice location:
  • Phone: 308-632-2540
  • Fax: 308-633-2650
Mailing address:
  • Phone: 308-632-2540
  • Fax: 308-633-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: BETSY VIDLAK
Title or Position: C.E.O.
Credential:
Phone: 308-635-3089