Organization Name: | OMAHA TRIBE OF NEBRASKA |
NPI Number: | 1609083914 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WEHNONA STABLER (CEO) |
Mailing Address: | 100 Indian Hills Drive Macy |
State: | NE US |
Postal Code: | 680390250 |
Phone Number: | 4028375381 |
Fax Number: | 4028375271 |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | ESRD046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |