Healthcare Provider Details

I. General information

NPI: 1922183516
Provider Name (Legal Business Name): LITZENBERG MEMORIAL COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

IV. Provider business mailing address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

V. Phone/Fax

Practice location:
  • Phone: 308-946-3015
  • Fax: 308-946-5914
Mailing address:
  • Phone: 308-946-3015
  • Fax: 308-946-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALS109
License Number StateNE

VIII. Authorized Official

Name: MICHAEL R BOWMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 308-946-3015