Provider Demographics
NPI:1346389327
Name:SAINT FRANCIS ALCOHOL AND DRUG TREATMENT CENTER
Entity Type:Organization
Organization Name:SAINT FRANCIS ALCOHOL AND DRUG TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:STALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LMHP
Authorized Official - Phone:308-398-5427
Mailing Address - Street 1:4305 SADDLE HORSE CT
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1011
Mailing Address - Country:US
Mailing Address - Phone:308-381-6647
Mailing Address - Fax:
Practice Address - Street 1:2116 W FAIDLEY AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4645
Practice Address - Country:US
Practice Address - Phone:308-398-5427
Practice Address - Fax:308-398-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE37324500000X
NE2862LMHP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility