Provider Demographics
NPI:1316019508
Name:BLUE VALLEY BEHAVIORAL HEALTH INC
Entity type:Organization
Organization Name:BLUE VALLEY BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP LCSW
Authorized Official - Phone:402-228-3386
Mailing Address - Street 1:1123 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-2041
Mailing Address - Country:US
Mailing Address - Phone:402-228-3386
Mailing Address - Fax:402-228-2004
Practice Address - Street 1:1123 N 9TH ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-2041
Practice Address - Country:US
Practice Address - Phone:402-228-3386
Practice Address - Fax:402-228-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NESATC 113251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE07697OtherBCBS
NE07697OtherBCBS
W49292Medicare UPIN