Provider Demographics
NPI:1023019718
Name:DOUGLAS COUNTY NEBRASKA
Entity Type:Organization
Organization Name:DOUGLAS COUNTY NEBRASKA
Other - Org Name:DOUGLAS COUNTY COMMUNITY MENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLASNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:402-444-7676
Mailing Address - Street 1:4102 WOOLWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1899
Mailing Address - Country:US
Mailing Address - Phone:402-444-7608
Mailing Address - Fax:
Practice Address - Street 1:4102 WOOLWORTH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1899
Practice Address - Country:US
Practice Address - Phone:402-444-7608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE260006283Q00000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025788600Medicaid
NE5380038OtherUHC PSYCH
NE0074OtherBC/BS PSYCH
NE096581Medicare ID - Type UnspecifiedPART B - BC/BS OF KS
NECE 1593Medicare ID - Type UnspecifiedPART B - RAILROAD
NE28-4009Medicare Oscar/Certification
NE5380038OtherUHC PSYCH
NE=========-08Medicaid
NE=========-07Medicaid
NE=========-10Medicaid
NE0074OtherBC/BS PSYCH
NE096581Medicare ID - Type UnspecifiedPART B - BC/BS OF KS
NE10025788600Medicaid