Provider Demographics
NPI:1922169358
Name:CATHOLIC CHARITIES OF THE ARCHDOICESE OF OMAHA
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE ARCHDOICESE OF OMAHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR BEHAVIORAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SASSATELLI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-829-9301
Mailing Address - Street 1:3300 N 60 ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104
Mailing Address - Country:US
Mailing Address - Phone:402-554-0520
Mailing Address - Fax:402-551-8797
Practice Address - Street 1:110 N 15 AVE
Practice Address - Street 2:STE 14A
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701
Practice Address - Country:US
Practice Address - Phone:402-371-3555
Practice Address - Fax:402-379-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE99 050OtherBCBS
NE99 050OtherBCBS
NE092619CAMedicare ID - Type Unspecified