Active NPI
Specialized Outpatient Services
- Community/Behavioral Health Agency
- Grand Island, NE
National Provider Identifier
1225868078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- SPECIALIZED OUTPATIENT SERVICES
- Practice address
- 1811 W 2ND Street
Suite 450
Grand Island, NE 68803 - Phone
- (308) 379-8619
- Fax
- (308) 675-2690
- NPI assigned
- Aug 6, 2024
- Organization subpart
- Yes
- Parent organization
- SPECIALIZED OUTPATIENT SERVICES LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cynthia L Kissack, LIMHP
- Title
- Supervisor
- Phone
- (308) 379-8619
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1811 W 2ND Street
Suite 450
Grand Island, NE 68803
Mailing address
1811 W 2ND Street
Suite 450
Grand Island, NE 68803
Phone (308) 379-8619
National Provider Directory
National Provider Directory- Tax ID family
- Specialized Outpatient Services
- Part of
- Specialized Outpatient Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Counselor
- Grand Island, NE
- NPI 1942848593
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Mental Health Counselor
- Grand Island, NE
- NPI 1942848593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722902400000",
"number": "1225868078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 W 2ND STREET",
"address_2": "SUITE 450",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "68803",
"telephone_number": "308-379-8619",
"fax_number": "308-675-2690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 W 2ND STREET",
"address_2": "SUITE 450",
"city": "GRAND ISLAND",
"state": "NE",
"postal_code": "68803",
"telephone_number": "308-379-8619",
"fax_number": "308-675-2690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECIALIZED OUTPATIENT SERVICES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SPECIALIZED OUTPATIENT SERVICES LLC",
"enumeration_date": "2024-08-06",
"last_updated": "2024-08-06",
"status": "A",
"authorized_official_last_name": "KISSACK",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "SUPERVISOR",
"authorized_official_telephone_number": "308-379-8619",
"authorized_official_credential": "LIMHP"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.