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General NPI Number Information
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NPI Number | 1942519830
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Entity Type | Organization
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Legal Business Name | KVC BEHAVIORALHEALTHCARE NEBRASKA, INC
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 5220 S 16TH ST
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City | LINCOLN
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State | NE
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Zip | 68512-1274
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Country | US
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Telephone | 402-477-0039
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Fax |
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Provider Business Mailing Address
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Address Line | 10909 MILL VALLEY RD STE 100
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City | OMAHA
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State | NE
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Zip | 68154-3950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SANDRA GASCA GONZALEZ
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Credential |
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Telephone | 402-301-1086
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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 |
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License Number State |
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