Provider Demographics
NPI:1306182688
Name:VOLUNTEERS OF AMERICA LEWELLEN, NE 69147
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA LEWELLEN, NE 69147
Other - Org Name:VOLUNTEERS OF AMERICA - WESTERN NEBRASKA
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:PLMHP
Authorized Official - Phone:308-778-5548
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:305 MAIN STREET
Mailing Address - City:LEWELLEN
Mailing Address - State:NE
Mailing Address - Zip Code:69147
Mailing Address - Country:US
Mailing Address - Phone:308-778-5548
Mailing Address - Fax:308-778-5547
Practice Address - Street 1:305 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LEWELLEN
Practice Address - State:NE
Practice Address - Zip Code:69147
Practice Address - Country:US
Practice Address - Phone:308-778-5548
Practice Address - Fax:308-778-5547
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOLUNTEERS OF AMERICA LEWELLEN, NEBRASKA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9843101YM0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty