Provider Demographics
NPI:1043759871
Name:INTEGRATED BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:INTEGRATED BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROMIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LUGINBILL
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:402-450-8645
Mailing Address - Street 1:2825 S 47TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3341
Mailing Address - Country:US
Mailing Address - Phone:402-450-8645
Mailing Address - Fax:
Practice Address - Street 1:2825 S 47TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3341
Practice Address - Country:US
Practice Address - Phone:402-450-8645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health