| Hines Psychotherapy Services, Inc. | |
|
3900 Dakota Ave Ste 4a South Sioux City NE 68776-3696 | |
| (402) 412-2000 | |
| (402) 412-2001 |
| Full Name | Hines Psychotherapy Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3900 Dakota Ave Ste 4a, South Sioux City, Nebraska |
| Authorized Official Name and Position | Nancy J. Hines (PRESIDENT) |
| Authorized Official Contact | 4024122000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hines Psychotherapy Services, Inc. 3900 Dakota Ave Ste 4a South Sioux City NE 68776-3696 Ph: (402) 412-2000 | Hines Psychotherapy Services, Inc. 3900 Dakota Ave Ste 4a South Sioux City NE 68776-3696 Ph: (402) 412-2000 |
| NPI Number | 1649450859 |
|---|---|
| Provider Enumeration Date | 11/06/2007 |
| Last Update Date | 11/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649450859 | NPI | - | NPPES |
| 6570263 | Medicaid | SD | |
| 82575 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2541 (MHP) (Nebraska) | Primary |
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