Provider Demographics
NPI:1932451499
Name:FAST FORWARD COMMUNITY CARE SERVICES, INC.
Entity type:Organization
Organization Name:FAST FORWARD COMMUNITY CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CLAYBORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-953-4183
Mailing Address - Street 1:3909 CUMING ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1225
Mailing Address - Country:US
Mailing Address - Phone:402-953-4183
Mailing Address - Fax:888-438-3351
Practice Address - Street 1:3909 CUMING ST STE 203
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-1225
Practice Address - Country:US
Practice Address - Phone:402-953-4183
Practice Address - Fax:888-438-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care