Provider Demographics
NPI:1043400807
Name:DEVELOPMENTAL SERVICES OF NEBRASKA, INC.
Entity Type:Organization
Organization Name:DEVELOPMENTAL SERVICES OF NEBRASKA, INC.
Other - Org Name:AFFINITY COMMUNITY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:L
Authorized Official - Last Name:STORTENBECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-435-2134
Mailing Address - Street 1:5701 THOMPSON CREEK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5686
Mailing Address - Country:US
Mailing Address - Phone:402-435-2800
Mailing Address - Fax:402-435-8801
Practice Address - Street 1:2610 W M CT
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-1006
Practice Address - Country:US
Practice Address - Phone:402-325-8555
Practice Address - Fax:402-325-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100251801-00Medicaid
NE100251107-00Medicaid
NE100251107-00Medicaid
NE=========-26Medicaid