=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669139481
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEST CENTRAL NEBRASKA AREA AGENCY ON AGING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2021
-----------------------------------------------------
Last Update Date | 11/29/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 N VINE ST
-----------------------------------------------------
City | NORTH PLATTE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69101-5305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-535-8195
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 115 N VINE ST
-----------------------------------------------------
City | NORTH PLATTE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69101-5305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-535-8195
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | ERIN ARENSDORF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 308-535-8195
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------