Provider Demographics
NPI:1346856747
Name:360 COMMUNITY SERVICES
Entity Type:Organization
Organization Name:360 COMMUNITY SERVICES
Other - Org Name:OPPORTUNITIES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-641-9125
Mailing Address - Street 1:14120 FREDERICK CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-6223
Mailing Address - Country:US
Mailing Address - Phone:402-641-9125
Mailing Address - Fax:
Practice Address - Street 1:9744 MOCKINGBIRD DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-2013
Practice Address - Country:US
Practice Address - Phone:402-800-3787
Practice Address - Fax:531-375-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty