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General NPI Number Information
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NPI Number | 1477966737
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Entity Type | Organization
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Legal Business Name | SERPA-ACO, LLC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 995 E HIGHWAY 33 SUITE 2
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City | CRETE
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State | NE
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Zip | 68333-5076
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Country | US
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Telephone | 402-826-3737
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Fax | 402-826-3746
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Provider Business Mailing Address
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Address Line | 995 E HIGHWAY 33 SUITE 2
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City | CRETE
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State | NE
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Zip | 68333-5076
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Country | US
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Telephone | 402-826-3737
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Fax | 402-826-3746
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOLEEN TENHULZEN HUNEKE
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Credential |
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Telephone | 402-826-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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