Healthcare Provider Details

I. General information

NPI: 1841611654
Provider Name (Legal Business Name): ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2013
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD SUITE 303
OMAHA NE
68124-2372
US

IV. Provider business mailing address

7710 MERCY RD SUITE 303
OMAHA NE
68124-2372
US

V. Phone/Fax

Practice location:
  • Phone: 402-343-4352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: EVERT KUIPER
Title or Position: CEO
Credential:
Phone: 402-343-4420