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General NPI Number Information
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NPI Number | 1396963930
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Entity Type | Organization
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Legal Business Name | LIFE QUEST INC.
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 201 COMMERCIAL
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City | PALMER
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State | NE
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Zip | 68864-0217
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Country | US
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Telephone | 308-894-3047
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Fax | 308-894-3057
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Provider Business Mailing Address
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Address Line | PO BOX 217
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City | PALMER
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State | NE
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Zip | 68864-0217
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Country | US
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Telephone | 308-894-3047
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Fax | 308-894-3057
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. NANCY LOUISE STEPHENS
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Credential | RN
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Telephone | 402-845-2745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MHC043
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License Number State | NE
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