Provider Demographics
NPI:1518770478
Name:SUPER STARTS CHILD DEVELOPMENT CENTER
Entity type:Organization
Organization Name:SUPER STARTS CHILD DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POETHIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-500-9706
Mailing Address - Street 1:5925 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-2229
Mailing Address - Country:US
Mailing Address - Phone:531-500-9705
Mailing Address - Fax:
Practice Address - Street 1:5925 ADAMS ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68507-2229
Practice Address - Country:US
Practice Address - Phone:531-500-9705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center