# EPWORTH VILLAGE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528310133
- **Authorized official:** STACI MOORMAN (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (402) 362-3353

## Contact information

- **Practice address:** 2119 N DIVISION AVE, YORK, NE 68467-1009
- **Practice address phone:** (402) 362-3353
- **Practice address fax:** (402) 363-7826
- **Mailing address:** 2119 N DIVISION AVE, YORK, NE 68467-1009
- **Mailing address phone:** (402) 362-3353
- **Mailing address fax:** (402) 363-7826

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 9746 | NE | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 10/05/2012