Basic Information
| Provider Information | |||||||||
| NPI: | 1073892675 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTERN NEBRASKA BEHAVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 779 | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | NE | ||||||||
| PostalCode: | 693600779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3083272026 | ||||||||
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| Practice Location | |||||||||
| Address1: | 309 W 3RD ST | ||||||||
| Address2: | |||||||||
| City: | RUSHVILLE | ||||||||
| State: | NE | ||||||||
| PostalCode: | 69360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3083272026 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2011 | ||||||||
| LastUpdateDate: | 08/12/2011 | ||||||||
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| AuthorizedOfficialLastName: | JONES-HAZLEDINE | ||||||||
| AuthorizedOfficialFirstName: | CATHERINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3084302630 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 631 | NE | Y | Agencies | Community/Behavioral Health |
No ID Information.