Provider Demographics
NPI:1336837137
Name:FIRST RESPONDERS FOUNDATION
Entity type:Organization
Organization Name:FIRST RESPONDERS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS AND DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-218-1234
Mailing Address - Street 1:10605 BURT CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2059
Mailing Address - Country:US
Mailing Address - Phone:402-218-1234
Mailing Address - Fax:
Practice Address - Street 1:10605 BURT CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2059
Practice Address - Country:US
Practice Address - Phone:402-218-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty