Healthcare Provider Details

I. General information

NPI: 1043400807
Provider Name (Legal Business Name): DEVELOPMENTAL SERVICES OF NEBRASKA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 W M CT
LINCOLN NE
68522-1006
US

IV. Provider business mailing address

5701 THOMPSON CREEK BLVD SUITE 200
LINCOLN NE
68516-5686
US

V. Phone/Fax

Practice location:
  • Phone: 402-325-8555
  • Fax: 402-325-8575
Mailing address:
  • Phone: 402-435-2800
  • Fax: 402-435-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ROGER L STORTENBECKER
Title or Position: CHIEF DEVELOPMENT OFFICER
Credential:
Phone: 402-435-2134