Provider Demographics
NPI:1740679125
Name:EARLY OPPORTUNITIES FOUNDATION
Entity type:Organization
Organization Name:EARLY OPPORTUNITIES FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:SLAGLE RADERMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LMHP
Authorized Official - Phone:402-657-1245
Mailing Address - Street 1:17604 T ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-2847
Mailing Address - Country:US
Mailing Address - Phone:402-657-1245
Mailing Address - Fax:
Practice Address - Street 1:17604 T ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-2847
Practice Address - Country:US
Practice Address - Phone:402-657-1245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2875101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty