Organization
SOUTHWEST AREA TRAINING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY BROUSSARD (ADMINISTRATOR)
(308) 345-1530
Entity
Organization
Contact information
Practice address
506 E 12TH ST, MC COOK, NE 69001-3599
(308) 345-1530
Mailing address
PO BOX 582, MC COOK, NE 69001-0582
(308) 345-1530
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75119852
—
NE
Enumeration date
12/13/2021
Last updated
02/27/2025
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