Provider Demographics
NPI:1700408465
Name:WOMEN'S EMPOWERING LIFE LINE, INC.
Entity Type:Organization
Organization Name:WOMEN'S EMPOWERING LIFE LINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY IMPROVEMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:LINDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-379-3622
Mailing Address - Street 1:910 WEST PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5044
Mailing Address - Country:US
Mailing Address - Phone:402-379-3622
Mailing Address - Fax:
Practice Address - Street 1:200 SOUTH 13TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701
Practice Address - Country:US
Practice Address - Phone:402-860-6080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S EMPOWERING LIFE LINE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100253122-02Medicaid
NE100252183-00Medicaid