Healthcare Provider Details

I. General information

NPI: 1902860190
Provider Name (Legal Business Name): CITY OF CRAWFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1ST & PADDOCK
CRAWFORD NE
69339
US

IV. Provider business mailing address

PO BOX 526 1ST & PADDOCK
CRAWFORD NE
69339
US

V. Phone/Fax

Practice location:
  • Phone: 308-665-1224
  • Fax: 308-665-2450
Mailing address:
  • Phone: 308-665-1224
  • Fax: 308-665-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number214002
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA J PERKINS
Title or Position: ADMINISTRATOR
Credential:
Phone: 308-665-1224