Provider Demographics
NPI:1295897239
Name:BEHAVIORAL HEALTH SPECIALISTS INC COLUMBUS CLINIC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH SPECIALISTS INC COLUMBUS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-370-3140
Mailing Address - Street 1:900 W NORFOLK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5006
Mailing Address - Country:US
Mailing Address - Phone:402-370-3140
Mailing Address - Fax:402-370-3373
Practice Address - Street 1:4432 SUNRISE PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3958
Practice Address - Country:US
Practice Address - Phone:402-564-9994
Practice Address - Fax:402-562-6458
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEHAVIORAL HEALTH SPECIALISTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-15
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025341800Medicaid
NE10025477400Medicaid