Basic Information
| Provider Information | |||||||||
| NPI: | 1164588604 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTERPOINTE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2633 P ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685033528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024758717 | ||||||||
| FaxNumber: | 4024756728 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 P ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685033630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024354044 | ||||||||
| FaxNumber: | 4024354051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON | ||||||||
| AuthorizedOfficialFirstName: | BEVERLY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIR. OF BUSINESS & FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 4024758717 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | NOT REQUIRED | NE | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | NOT REQUIRED | NE | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 251B00000X | NOT REQUIRED | NE | X | Agencies | Case Management |
ID Information
| ID | Type | State | Issuer | Description | 10025369900 | 05 | NE | MEDICAID |