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Intermediate Care Facility, Mental Illness

Bellevue, Nebraska

Provider NPI: 1679517684

Organization Information:

Practice Location:
Tel: 402-291-1203  Fax: --

Business Mailing Address:
Tel: --  Fax: --


PrimaryCodeCategory/DescriptionStateLicense Number
Psychiatry & Neurology
Addiction Medicine
Psychiatry & Neurology
Y320800000XResidential Treatment Facilities
Community Based Residential Treatment Facility, Mental Illness

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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