Basic Information
| Provider Information | |||||||||
| NPI: | 1124331590 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTERPOINTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2633 P ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685033528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024755161 | ||||||||
| FaxNumber: | 4024753300 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 S 13TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685083533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024755161 | ||||||||
| FaxNumber: | 4024753300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2010 | ||||||||
| LastUpdateDate: | 07/14/2010 | ||||||||
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| AuthorizedOfficialLastName: | RICE | ||||||||
| AuthorizedOfficialFirstName: | ASHLEY | ||||||||
| AuthorizedOfficialMiddleName: | SARA | ||||||||
| AuthorizedOfficialTitleorPosition: | CASE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4024755161 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.