Healthcare Provider Details

I. General information

NPI: 1023019718
Provider Name (Legal Business Name): DOUGLAS COUNTY NEBRASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 WOOLWORTH AVE
OMAHA NE
68105-1899
US

IV. Provider business mailing address

4102 WOOLWORTH AVE
OMAHA NE
68105-1899
US

V. Phone/Fax

Practice location:
  • Phone: 402-444-7608
  • Fax:
Mailing address:
  • Phone: 402-444-7608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number260006
License Number StateNE

VIII. Authorized Official

Name: MRS. SHERRY L DRIVER
Title or Position: DIRECTOR
Credential: LIMHP
Phone: 402-444-7676