Provider Demographics
NPI:1285676544
Name:FAITH REGIONAL HEALTH SERVICES
Entity Type:Organization
Organization Name:FAITH REGIONAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-371-4880
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68702-0869
Mailing Address - Country:US
Mailing Address - Phone:402-644-7249
Mailing Address - Fax:402-644-7432
Practice Address - Street 1:2700 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4438
Practice Address - Country:US
Practice Address - Phone:402-371-4880
Practice Address - Fax:402-644-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE520002273R00000X, 282N00000X
NE520001282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00517OtherBCBS PSYCH
NE00519OtherBCBS ACUTE
WY118248000Medicaid
NE5000020OtherUNITED HEALTHCARE
CO71907866Medicaid
NE00521OtherBCBS OP SA
NE0006400415OtherAETNA
SD0130790Medicaid
IA0544858Medicaid
SD5530790Medicaid
MN363673900Medicaid
MO016120701Medicaid
IA0518050Medicaid
IA0518050Medicaid
NE00517OtherBCBS PSYCH
NE=========001OtherTRICARE
IA0544858Medicaid
MN363673900Medicaid
NE=========28Medicaid