Provider Demographics
NPI:1578872461
Name:KVC BEHAVIORAL HEALTHCARE NEBRASKA, INC
Entity Type:Organization
Organization Name:KVC BEHAVIORAL HEALTHCARE NEBRASKA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASCA GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-301-1086
Mailing Address - Street 1:10909 MILL VALLEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3950
Mailing Address - Country:US
Mailing Address - Phone:402-431-4200
Mailing Address - Fax:
Practice Address - Street 1:1413 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4165
Practice Address - Country:US
Practice Address - Phone:402-939-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health