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Organization

GRACE CHILDRENS HOME INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN DOUGLAS RADER (PROGRAM DIRECTOR)
(402) 723-5725
Entity
Organization

Contact information

Practice address
1033 N MAIN, HENDERSON, NE 68371-0519
(402) 723-5725
(402) 723-5718
Mailing address
1033 N MAIN, HENDERSON, NE 68371-0519
(402) 723-5725
(402) 723-5718

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
2084P0804X
Child & Adolescent Psychiatry Physician

Other

Enumeration date
05/02/2008
Last updated
05/02/2008
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