Provider Demographics
NPI:1508289455
Name:SOUTH CENTRAL BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:SOUTH CENTRAL BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUEGGEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-237-5951
Mailing Address - Street 1:724 S BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5913
Mailing Address - Country:US
Mailing Address - Phone:402-463-7435
Mailing Address - Fax:
Practice Address - Street 1:724 S BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5913
Practice Address - Country:US
Practice Address - Phone:402-463-7435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health