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General NPI Number Information
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NPI Number | 1649443151
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Entity Type | Organization
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Legal Business Name | GOODWILL INDUSTRIES OF GREATE NEBRASKA, INC
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Dates
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Enumeration Date | 04/04/2008
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 1804 S EDDY ST
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City | GRAND ISLAND
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State | NE
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Zip | 68801-7114
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Country | US
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Telephone | 308-384-7896
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Fax | 308-382-6802
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Provider Business Mailing Address
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Address Line | P.O. BOX 1863
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City | GRAND ISLAND
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State | NE
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Zip | 68802
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Country | US
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Telephone | 308-384-7896
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Fax | 308-382-6802
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Authorized Official
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Title or Position | DIRECTOR OF BEHAVIORAL HEALTH SERV
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Name | BECKY JANULEWICZ
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Credential |
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Telephone | 308-384-7896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 58
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License Number State | NE
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