SOUTH CENTRAL BEHAVIORAL SERVICES , NPI 1740377472 — KEARNEY (NE)

NPI 1740377472

13+ Years Experience Organization

SOUTH CENTRAL BEHAVIORAL SERVICES

10.06.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1740377472
NPI NUMBER

About SOUTH CENTRAL BEHAVIORAL SERVICES

SOUTH CENTRAL BEHAVIORAL SERVICES is a provider established in KEARNEY, NE. The NPI number of SOUTH CENTRAL BEHAVIORAL SERVICES is 1740377472 and was assigned on 10.06.2006. The practitioners primary taxonomy code is: 261QM0801X with license number: SATC066 NE .

Mailing address

  • City: KEARNEY
  • State: NE
  • Postal code: 688481715
  • Phone: 3082375951
  • Fax: 3082344018
  • Address: PO BOX 1715

Primary Practice Address

  • Region : KEARNEY, NE
  • NPI : 1740377472
  • Phone : 3082375951
  • Fax : 3082344018
  • Postalcode : 688478134
  • Address : 3810 CENTRAL AVE

Additional identifiers

  • Identifier: 10025305400
  • Code / Type : 5 - MEDICAID
  • Identifier state : NE

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QM0801X
  • License number: SATC066
  • License state: NE

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

Click to Show Map
  • SOUTH CENTRAL BEHAVIORAL SERVICES
  • Address : 3810 CENTRAL AVE
  • Region : KEARNEY, NE
  • NPI : 1740377472
  • Phone : 3082375951
  • Fax : 3082344018
  • Postalcode : 688478134

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3082375951
  • Title or position : CEO
  • Credentials : LMHP MSW

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3810 CENTRAL AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameKEARNEY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNE
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code688478134
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3082375951
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3082344018
The fax number associated with the location address of the provider being identified.
NPI1740377472
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QM0801X
Provider Enumeration Date10.06.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)SOUTH CENTRAL BEHAVIORAL SERVICES
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 1715
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameKEARNEY
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code688481715
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3082375951
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3082344018
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameHENRIE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameGARY
The first name of the authorized official
Authorized Official Middle NameW
The middle name of the authorized official
Authorized Official Title or PositionCEO
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Credential TextLMHP MSW
Authorized Official Credential Text
Authorized Official Telephone Number3082375951
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QM0801X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Provider License Number 1SATC066
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NE
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 110025305400
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1NE
Other Provider Identifier State #1
X

Share this page?