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General NPI Number Information
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NPI Number | 1538466180
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Entity Type | Organization
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Legal Business Name | THE CENTRAL NEBRASKA CHILD ADVOCACY CENTER, INC.
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 721 W KOENIG ST
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City | GRAND ISLAND
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State | NE
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Zip | 68801-6555
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Country | US
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Telephone | 308-385-5238
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Fax | 308-385-5239
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Provider Business Mailing Address
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Address Line | 721 W. KOENIG
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City | GRAND ISLAND
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State | NE
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Zip | 68801-6555
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Country | US
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Telephone | 308-385-5238
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Fax | 308-385-5239
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. VIRGINIA LEA VELANDER
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Credential |
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Telephone | 308-385-5238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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