Healthcare Provider Details

I. General information

NPI: 1811086721
Provider Name (Legal Business Name): CREIGHTON AREA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 11/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 MAIN ST
CREIGHTON NE
68729-2999
US

IV. Provider business mailing address

PO BOX 289
CREIGHTON NE
68729-0289
US

V. Phone/Fax

Practice location:
  • Phone: 402-358-5701
  • Fax: 402-358-5769
Mailing address:
  • Phone: 402-358-5701
  • Fax: 402-358-5769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberLTCH008
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLTCH008
License Number StateNE

VIII. Authorized Official

Name: MS. KIMBERLY J. HIXSON
Title or Position: CFO
Credential:
Phone: 402-358-5715