Healthcare Provider Details

I. General information

NPI: 1376081521
Provider Name (Legal Business Name): CENTERPOINTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 N 16TH ST
OMAHA NE
68102-4101
US

IV. Provider business mailing address

2633 P ST
LINCOLN NE
68503-3528
US

V. Phone/Fax

Practice location:
  • Phone: 402-827-0570
  • Fax: 402-827-0580
Mailing address:
  • Phone: 402-475-8717
  • Fax: 402-475-8721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TOPHER HANSEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: JD
Phone: 402-475-8717