Organization
EPWORTH VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS G. MCBRIDE (PRESIDENT/CEO)
(402) 362-3353
Entity
Organization
Contact information
Practice address
2119 N DIVISION AVE, YORK, NE 68467-1009
(402) 362-3353
Mailing address
PO BOX 503, 2119 DIVISION AVE., YORK, NE 68467-0503
(402) 362-3353
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
79772233
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100260385-00
—
NE
05
—
100260386-00
—
NE
05
—
100260387-00
—
NE
05
—
100260389-00
—
NE
05
—
100260401-00
—
NE
05
—
100260591-00
—
NE
Enumeration date
07/13/2006
Last updated
09/21/2011
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