Organization · Type 2 NPI

State of Nebraska Dept of Admin Services

Health Service Clinic/Center · Lincoln, NE

NPI number 1063253714 Active

Practice location

3218 W Van Dorn St
Lincoln, NE 68522-9278

Fax (402) 479-6100

Specialties and licenses

Taxonomy	Code	License
Health Service Clinic/Center Primary	261QH0100X	None listed

Health Service Clinic/Center: Definition to come...

2 other providers at this address

Dustin Joseph Robinson, AGACNP-BCNurse Practitioner Lincoln, NE NPI 1508737693
Elianet Tamayo Pioto, PLMHPMental Health Counselor Lincoln, NE NPI 1487482881

Other health service clinic/center providers in Lincoln

See all in Lincoln →

NPI record

NPI: 1063253714
Entity type: Organization (Type 2)
Issued: Jun 5, 2024
Last updated: Jun 5, 2024
Status: Active
Subpart: Yes of State of Nebraska Dept of Admin Services

Other names

NDCS Reception and Treatment Center · other name

Authorized official

Cassandra Jane Putnam
Health Care Administrator
(402) 479-5630

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1063253714

State of Nebraska Dept of Admin Services's National Provider Identifier is 1063253714, issued on Jun 5, 2024. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Lincoln, NE. The record was last updated on Jun 5, 2024.