Provider Demographics
NPI:1487668471
Name:THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:THE LANNING CENTER FOR BEHAVIORAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-461-5108
Mailing Address - Street 1:835 S BURLINGTON AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-6912
Mailing Address - Country:US
Mailing Address - Phone:402-463-7711
Mailing Address - Fax:
Practice Address - Street 1:835 S BURLINGTON AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-6912
Practice Address - Country:US
Practice Address - Phone:402-463-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-28
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098344Medicare PIN