Healthcare Provider Details

I. General information

NPI: 1659392454
Provider Name (Legal Business Name): WINNEBAGO INDIAN HEALTH SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 77/75
WINNEBAGO NE
68071
US

IV. Provider business mailing address

PO BOX HH
WINNEBAGO NE
68071-0767
US

V. Phone/Fax

Practice location:
  • Phone: 402-878-2231
  • Fax: 402-878-2237
Mailing address:
  • Phone: 402-878-2231
  • Fax: 402-878-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DARLA M MCCLOSKEY
Title or Position: IOP DIRECTOR
Credential:
Phone: 402-878-2231