Provider Demographics
NPI:1427420017
Name:MOBILE HEARING OF NEBRASKA LLC
Entity Type:Organization
Organization Name:MOBILE HEARING OF NEBRASKA LLC
Other - Org Name:SPECIAL CARE HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENDLIK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CC-A
Authorized Official - Phone:855-259-9183
Mailing Address - Street 1:12910 SHELBYVILLE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-2404
Mailing Address - Country:US
Mailing Address - Phone:855-259-9183
Mailing Address - Fax:502-254-4069
Practice Address - Street 1:2129 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-4521
Practice Address - Country:US
Practice Address - Phone:855-259-9183
Practice Address - Fax:502-254-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE127231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty