Provider Demographics
NPI:1578603833
Name:HOPESPOKE
Entity Type:Organization
Organization Name:HOPESPOKE
Other - Org Name:CHILD GUIDANCE CENTER RESIDENTIAL TREATMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEESE STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-475-7666
Mailing Address - Street 1:2444 O STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510
Mailing Address - Country:US
Mailing Address - Phone:402-475-7666
Mailing Address - Fax:402-476-9623
Practice Address - Street 1:904 SUMNER
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502
Practice Address - Country:US
Practice Address - Phone:402-434-2670
Practice Address - Fax:402-434-2672
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPESPOKE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEMHC045323P00000X, 323P00000X
NE90316759323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026041400Medicaid
=========OtherALL INSURANCES
NE=========00Medicaid