=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568758373
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY ACTION PARTNERSHIP OF MID-NEBRASKA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2011
-----------------------------------------------------
Last Update Date | 06/21/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16 W 11TH ST
-----------------------------------------------------
City | KEARNEY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68847-7440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-865-5675
-----------------------------------------------------
Fax | 308-865-5681
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2288 16 WEST 11TH ST
-----------------------------------------------------
City | KEARNEY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68848-2288
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-865-5675
-----------------------------------------------------
Fax | 308-865-5681
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MS. KAREN K LUECK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 308-865-5675
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------