Provider Demographics
NPI:1568568202
Name:HASTINGS COMMUNITY PSYCHIATRY LLC
Entity Type:Organization
Organization Name:HASTINGS COMMUNITY PSYCHIATRY LLC
Other - Org Name:GIAVANNA P BOUTHIETTED MD MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MS
Authorized Official - First Name:GIAVANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BOUTHIETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-461-3520
Mailing Address - Street 1:209 W 9TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3971
Mailing Address - Country:US
Mailing Address - Phone:402-461-3520
Mailing Address - Fax:402-461-3527
Practice Address - Street 1:209 W 9TH ST STE D
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3971
Practice Address - Country:US
Practice Address - Phone:402-461-3520
Practice Address - Fax:402-461-3527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty