Provider Demographics
NPI:1871241315
Name:HOMETOWN BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:HOMETOWN BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAMME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-274-8853
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:TALMAGE
Mailing Address - State:NE
Mailing Address - Zip Code:68448-0184
Mailing Address - Country:US
Mailing Address - Phone:402-274-8853
Mailing Address - Fax:
Practice Address - Street 1:2115 14TH ST STE 100
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305-1760
Practice Address - Country:US
Practice Address - Phone:402-274-4993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health