Provider Demographics
NPI:1558657155
Name:REGION II HUMAN SERVICES
Entity Type:Organization
Organization Name:REGION II HUMAN SERVICES
Other - Org Name:FRONTIER HOUSE DAY REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEACREST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-534-0440
Mailing Address - Street 1:PO BOX 1209
Mailing Address - Street 2:114 SOUTH CHESTNUT
Mailing Address - City:NORTH PLATT
Mailing Address - State:NE
Mailing Address - Zip Code:69103
Mailing Address - Country:US
Mailing Address - Phone:305-532-4730
Mailing Address - Fax:308-532-4737
Practice Address - Street 1:114 SOUTH CHESTNUT
Practice Address - Street 2:
Practice Address - City:NORTH PLATT
Practice Address - State:NE
Practice Address - Zip Code:69103
Practice Address - Country:US
Practice Address - Phone:305-532-4730
Practice Address - Fax:308-532-4737
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGION II HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE71251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
092511Medicare PIN