Provider Demographics
NPI:1801131495
Name:MID-PLAINS CENTER FOR BEHAVIORAL HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:MID-PLAINS CENTER FOR BEHAVIORAL HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HUMAN RESOURCES
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BYDALEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-395-1067
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-1763
Mailing Address - Country:US
Mailing Address - Phone:308-395-1010
Mailing Address - Fax:
Practice Address - Street 1:615 N ELM ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-4254
Practice Address - Country:US
Practice Address - Phone:308-395-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)