NPIMap

Organization Active NPI

Southwest Area Training Service

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • McCook, NE
National Provider Identifier
1164181590
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
SOUTHWEST AREA TRAINING SERVICE
Practice address
506 E 12TH St
MC Cook, NE 69001-3599
Phone
(308) 345-1530
NPI assigned
Dec 13, 2021
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mandy BroussardNPI 1376340281
Title
Administrator
Phone
(308) 345-1530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

506 E 12TH St
MC Cook, NE 69001-3599

Mailing address

PO Box 582
MC Cook, NE 69001-0582
Phone (308) 345-1530

Other identifiers 1

IdentifierTypeStateIssuer
75119852MedicaidNE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1164181590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 582",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690010582",
            "telephone_number": "308-345-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E 12TH ST",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013599",
            "telephone_number": "308-345-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST AREA TRAINING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "MANDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-345-1530"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75119852",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McCook, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.