Provider Demographics
NPI:1851625750
Name:NEBRASKA COMPREHENSIVE HEALTH CARE
Entity Type:Organization
Organization Name:NEBRASKA COMPREHENSIVE HEALTH CARE
Other - Org Name:NEBRASKA MENTAL HEALTH CENTERS P C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:B R
Authorized Official - Last Name:NESSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:402-483-6990
Mailing Address - Street 1:4545 S 86TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9227
Mailing Address - Country:US
Mailing Address - Phone:402-483-6990
Mailing Address - Fax:402-483-7045
Practice Address - Street 1:4545 S 86TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9227
Practice Address - Country:US
Practice Address - Phone:402-483-6990
Practice Address - Fax:402-483-7045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE365103TC0700X
NE25338207Q00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025778400Medicaid
NEPENDINGMedicare PIN