Provider Demographics
NPI:1730233990
Name:CEDARS YOUTH SERVICES
Entity type:Organization
Organization Name:CEDARS YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-437-8825
Mailing Address - Street 1:6601 PIONEERS BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5260
Mailing Address - Country:US
Mailing Address - Phone:402-434-5437
Mailing Address - Fax:402-437-8833
Practice Address - Street 1:6601 PIONEERS BLVD
Practice Address - Street 2:STE 1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5260
Practice Address - Country:US
Practice Address - Phone:402-434-5437
Practice Address - Fax:402-437-8833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100255596-00Medicaid
NE=========26Medicaid
NE=========34Medicaid
NE100255596-00Medicaid
NE=========38Medicaid