Provider Demographics
NPI:1861099475
Name:GREAT PLAINS AREA REGIONAL DRUG DEPENDENCY UNIT
Entity type:Organization
Organization Name:GREAT PLAINS AREA REGIONAL DRUG DEPENDENCY UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:402-878-3565
Mailing Address - Street 1:PO BOX 423
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-0423
Mailing Address - Country:US
Mailing Address - Phone:402-878-3414
Mailing Address - Fax:402-878-2055
Practice Address - Street 1:113 S BLUFF ST
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-9704
Practice Address - Country:US
Practice Address - Phone:402-878-3414
Practice Address - Fax:402-878-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility