Provider Demographics
NPI:1568790483
Name:KVC BEHAVIORAL HEALTHCARE NEBRASKA, INC
Entity Type:Organization
Organization Name:KVC BEHAVIORAL HEALTHCARE NEBRASKA, INC
Other - Org Name:KVC NEBRASKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:402-498-4710
Mailing Address - Street 1:11550 I ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1222
Mailing Address - Country:US
Mailing Address - Phone:402-498-4700
Mailing Address - Fax:402-493-3340
Practice Address - Street 1:5001 CENTRAL PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3461
Practice Address - Country:US
Practice Address - Phone:402-742-8800
Practice Address - Fax:402-477-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025836600Medicaid