Provider Demographics
NPI:1730280371
Name:OMAHA THERAPY, INC
Entity Type:Organization
Organization Name:OMAHA THERAPY, INC
Other - Org Name:REHAB VISIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR ACCOUNTANT/DELEGATED OFFICIA
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-334-6025
Mailing Address - Street 1:11623 ARBOR ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2991
Mailing Address - Country:US
Mailing Address - Phone:402-334-6025
Mailing Address - Fax:402-334-6081
Practice Address - Street 1:683 STATE AVE STE B
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-4660
Practice Address - Country:US
Practice Address - Phone:701-483-9400
Practice Address - Fax:701-483-9398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OMAHA THERAPY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-26
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND52114Medicaid
ND52114Medicaid