Healthcare Provider Details

I. General information

NPI: 1912235458
Provider Name (Legal Business Name): KVC BEHAVIORAL HEALTHCARE NEBRASKA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2009
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 I ST STE 100
OMAHA NE
68137-1222
US

IV. Provider business mailing address

11550 I ST STE 100
OMAHA NE
68137-1222
US

V. Phone/Fax

Practice location:
  • Phone: 402-498-4700
  • Fax: 402-493-3340
Mailing address:
  • Phone: 402-498-4700
  • Fax: 402-493-3340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ASHLEY DAWN BROWN
Title or Position: PRESIDENT
Credential:
Phone: 402-498-4700