Provider Demographics
NPI:1578690152
Name:HOUSES OF HOPE OF NEBRASKA, INC
Entity type:Organization
Organization Name:HOUSES OF HOPE OF NEBRASKA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:402-435-3165
Mailing Address - Street 1:1124 N COTNER BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1834
Mailing Address - Country:US
Mailing Address - Phone:402-435-3165
Mailing Address - Fax:402-435-0430
Practice Address - Street 1:6445 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-1853
Practice Address - Country:US
Practice Address - Phone:402-435-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSES OF HOPE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-28
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025218400Medicaid