Healthcare Provider Details

I. General information

NPI: 1245642396
Provider Name (Legal Business Name): SCOTT ADULT FAMILY ENTERPRISES, NEBRASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2014
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5966 SILVER BROOK PL
LINCOLN NE
68521-5413
US

IV. Provider business mailing address

5966 SILVER BROOK PL
LINCOLN NE
68521-5413
US

V. Phone/Fax

Practice location:
  • Phone: 402-853-4332
  • Fax:
Mailing address:
  • Phone: 402-853-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ARTHUR WADE SCOTT
Title or Position: DIRECTOR
Credential: MA
Phone: 402-853-4332