NPIMap

Organization Active NPI

Bryan LGH West Independence Center

  • Substance Abuse Rehabilitation Facility
  • Lincoln, NE
National Provider Identifier
1578852968
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
832 Issued in NE
Legal business name
BRYAN LGH WEST INDEPENDENCE CENTER
Practice address
1650 Lake St
Lincoln, NE 68502-3734
Phone
(402) 481-5268
Fax
(402) 481-5495
NPI assigned
Apr 6, 2011
Last updated
Apr 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Eric N Mooss
Title
President/Ceo
Phone
(402) 481-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 832 NE Primary

Addresses

Primary practice location

1650 Lake St
Lincoln, NE 68502-3734

Mailing address

1650 Lake St
Lincoln, NE 68502-3734
Phone (402) 481-5268

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@hisp.bryanhealth.org

National Provider Directory

National Provider Directory
Tax ID family
BMH Professional Billin13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1578852968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LAKE ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023734",
            "telephone_number": "402-481-5268",
            "fax_number": "402-481-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LAKE ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685023734",
            "telephone_number": "402-481-5268",
            "fax_number": "402-481-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN LGH WEST INDEPENDENCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "MOOSS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "402-481-1111"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NE",
            "license": "832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@hisp.bryanhealth.org",
            "affiliation": "N",
            "address_1": "1600 S 48th St",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685061299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.

Verify at the official NPI Registry.