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General NPI Number Information
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NPI Number | 1982913943
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Entity Type | Organization
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Legal Business Name | COMMUNITY ACTION PARTNERSHIP OF WESTERN NEBRASKA
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 975 CRESCENT DR
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City | GERING
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State | NE
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Zip | 69341-1712
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Country | US
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Telephone | 308-632-2540
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Fax | 308-633-2650
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Provider Business Mailing Address
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Address Line | 3350 10TH ST
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City | GERING
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State | NE
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Zip | 69341-1724
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Country | US
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Telephone | 308-635-3089
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Fax | 308-635-0264
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JAN FITTS
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Credential |
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Telephone | 308-635-3089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | HC023
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License Number State | NE
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