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NPI Code Detail

MEDICARE: VSL LINCOLN SUMNER LLC

MEDICARE: VSL LINCOLN SUMNER LLC
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
1314000000XSkilled Nursing Facility504008NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1504008OTHERNEFACILITY LICENSE

General Provider Information

NPI Number : 1831629468
Entity Type Code : Organization
Provider Name (Legal Business Name) : VSL LINCOLN SUMNER LLC
Provider Business Mailing Address
First Line : 20220 HARNEY ST
Second Line :
City : ELKHORN
State : NE
Zip : 68022-2063
Country : US
Telephone Number : 402-885-6120
Fax Number : 402-895-8165
Provider Business Practice Location Address
First Line : 1750 S 20TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68502-2611
Country : US
Telephone Number : 402-475-6791
Fax Number : 402-475-3792
Authorized Official
Title or Position : CEO
Name : JACK D VETTER
Credential :
Telephone Number : 402-895-3932
Provider Enumeration Date : 06/15/2017
Last Update Date : 07/24/2025

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Directions to “VSL LINCOLN SUMNER LLC ” Practice Location

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