Provider Demographics
NPI:1639615198
Name:THE LINK DUAL RECOVERY PROGRAM
Entity Type:Organization
Organization Name:THE LINK DUAL RECOVERY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP, LADC
Authorized Official - Phone:402-371-5310
Mailing Address - Street 1:305 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3915
Mailing Address - Country:US
Mailing Address - Phone:402-999-4771
Mailing Address - Fax:402-370-9810
Practice Address - Street 1:305 N 9TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3915
Practice Address - Country:US
Practice Address - Phone:402-999-4771
Practice Address - Fax:402-370-9810
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LINK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE252320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness