Provider Demographics
NPI:1396634770
Name:MOVING MOUNTAINS DEVELOPMENTAL SERVICES, LLC
Entity type:Organization
Organization Name:MOVING MOUNTAINS DEVELOPMENTAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-812-6676
Mailing Address - Street 1:4595 N 190TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-4685
Mailing Address - Country:US
Mailing Address - Phone:402-812-6676
Mailing Address - Fax:
Practice Address - Street 1:5408 AMES AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104
Practice Address - Country:US
Practice Address - Phone:531-375-5575
Practice Address - Fax:531-772-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities