Basic Information
| Provider Information | |||||||||
| NPI: | 1801986898 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY ALTERNATIVES NEBRASKA, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10140 LINN STATION RD | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402233813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5023942387 | ||||||||
| FaxNumber: | 5023942285 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 FOLKWAYS CIR | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685044762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024202100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 10/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | OMBRES | ||||||||
| AuthorizedOfficialFirstName: | DEENA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRIVACY OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5023942387 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | N | Agencies | Day Training, Developmentally Disabled Services | 320600000X | N | Residential Treatment Facilities | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320800000X | N | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | 320900000X | Y | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
ID Information
| ID | Type | State | Issuer | Description | 44592216 | 05 | NE | MEDICAID | 74933117 | 05 | NE | MEDICAID |