Provider Demographics
NPI:1134683857
Name:THE VESSEL NETWORK LLC
Entity Type:Organization
Organization Name:THE VESSEL NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KLAYE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-817-3736
Mailing Address - Street 1:4517 N 167TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2961
Mailing Address - Country:US
Mailing Address - Phone:402-817-3736
Mailing Address - Fax:402-998-5185
Practice Address - Street 1:4517 N 167TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2961
Practice Address - Country:US
Practice Address - Phone:402-817-3736
Practice Address - Fax:402-998-5185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities