Provider Demographics
NPI:1558303743
Name:MID-PLAINS CENTER FOR BEHAVIORAL HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:MID-PLAINS CENTER FOR BEHAVIORAL HEALTHCARE SERVICES, INC.
Other - Org Name:MID-PLAINS CENTER FOR PROFESSIONAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:308-395-1040
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-1763
Mailing Address - Country:US
Mailing Address - Phone:308-385-5250
Mailing Address - Fax:308-385-5271
Practice Address - Street 1:914 BAUMANN DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4401
Practice Address - Country:US
Practice Address - Phone:308-385-5250
Practice Address - Fax:308-385-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100253668-00Medicaid
NE=========-00Medicaid
NE=========-26Medicaid
NE=========-30Medicaid
NE=========-00Medicaid