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NPI Code Detail

MEDICARE: LOUISVILLE CARE CENTER ASSISTED LIVING

MEDICARE: LOUISVILLE CARE CENTER ASSISTED LIVING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityALF313NE

General Provider Information

NPI Number : 1407156268
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOUISVILLE CARE CENTER ASSISTED LIVING
Provider Business Mailing Address
First Line : 410 W 5TH ST
Second Line :
City : LOUISVILLE
State : NE
Zip : 68037-6006
Country : US
Telephone Number : 402-234-2125
Fax Number : 402-234-2431
Provider Business Practice Location Address
First Line : 410 W 5TH ST
Second Line :
City : LOUISVILLE
State : NE
Zip : 68037-6006
Country : US
Telephone Number : 402-234-2125
Fax Number : 402-234-2431
Authorized Official
Title or Position : ADMINISTRATOR
Name : KARI ANN WOCKENFUSS
Credential :
Telephone Number : 402-234-2125
Provider Enumeration Date : 10/27/2010
Last Update Date : 10/27/2010

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1952851420 — DANIEL BROCKEVELT
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Directions to “LOUISVILLE CARE CENTER ASSISTED LIVING ” Practice Location

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