Organization
COMMUNITY LIFE SKILLS CONNECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI THOMAS-DAVIS RN, MSN (EXECUTIVE DIRECTOR)
(402) 690-0475
Entity
Organization
Contact information
Practice address
3830 BURT ST, OMAHA, NE 68131-1819
(402) 690-0475
Mailing address
PO BOX 1928, COUNCIL BLUFFS, IA 51502-1928
(402) 690-0475
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
399679
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S00000X
—
IA
Enumeration date
06/28/2010
Last updated
06/28/2010
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