Organization
COOPER VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SONJA SUE MCKAY (BILLING COORDINATOR)
(402) 457-1398
Entity
Organization
Contact information
Practice address
8502 MORMON BRIDGE RD, OMAHA, NE 68152-2150
(402) 457-1398
(402) 457-1405
Mailing address
8502 MORMON BRIDGE RD, PO BOX 12150, OMAHA, NE 68152-2150
(402) 457-1398
(402) 457-1405
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
MHC016
NE
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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