Provider Demographics
NPI:1982419818
Name:RAKOSKY, ALAN
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:RAKOSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2215
Mailing Address - Country:US
Mailing Address - Phone:308-850-5518
Mailing Address - Fax:
Practice Address - Street 1:4229 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2215
Practice Address - Country:US
Practice Address - Phone:308-850-5519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services