Healthcare Provider Details

I. General information

NPI: 1245478197
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF THE ARCHDIOCESE OF OMAHA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 M ST
OMAHA NE
68137-2378
US

IV. Provider business mailing address

3300 N 60TH ST
OMAHA NE
68104-3402
US

V. Phone/Fax

Practice location:
  • Phone: 402-898-4135
  • Fax: 402-551-8797
Mailing address:
  • Phone: 402-554-0520
  • Fax: 402-551-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License NumberSATC153
License Number StateNE

VIII. Authorized Official

Name: THERESA ROSS
Title or Position: SENIOR FINANCE DIRECTOR
Credential:
Phone: 402-829-9292