Provider Demographics
NPI:1194197053
Name:MID-PLAINS CENTER FOR BEHAVIORAL HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:MID-PLAINS CENTER FOR BEHAVIORAL HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR/MARKETING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:PYCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-395-1046
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-1763
Mailing Address - Country:US
Mailing Address - Phone:308-395-1046
Mailing Address - Fax:308-395-1060
Practice Address - Street 1:210 GATEWAY MALL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2489
Practice Address - Country:US
Practice Address - Phone:402-261-9273
Practice Address - Fax:402-261-9274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10669261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health