Provider Demographics
NPI:1528221942
Name:DEVELOPMENTAL SERVICES OF NEBRASKA INC
Entity Type:Organization
Organization Name:DEVELOPMENTAL SERVICES OF NEBRASKA INC
Other - Org Name:DSN KC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHEIF DEVELOPMENT OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-435-2134
Mailing Address - Street 1:5701 THOMPSON CREEK BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5600
Mailing Address - Country:US
Mailing Address - Phone:402-435-2134
Mailing Address - Fax:
Practice Address - Street 1:5701 THOMPSON CREEK BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5600
Practice Address - Country:US
Practice Address - Phone:402-435-2134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEVELOPMENTAL SERVICES OF NEBRASKA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE348216000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO856344205Medicaid
NE100251801-00Medicaid
NE100251107-00Medicaid