Provider Demographics
NPI:1407076995
Name:WESTERN VOCATIONAL SERVICES, INC
Entity Type:Organization
Organization Name:WESTERN VOCATIONAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-463-6987
Mailing Address - Street 1:101 S HASTINGS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-6039
Mailing Address - Country:US
Mailing Address - Phone:402-463-6987
Mailing Address - Fax:
Practice Address - Street 1:101 S HASTINGS AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-6039
Practice Address - Country:US
Practice Address - Phone:402-463-6987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========26Medicaid