Provider Demographics
NPI:1982144457
Name:SCOTT, JAMES (EDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-2967
Mailing Address - Country:US
Mailing Address - Phone:402-853-4332
Mailing Address - Fax:
Practice Address - Street 1:5400 WALKER AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-2967
Practice Address - Country:US
Practice Address - Phone:402-853-4332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services