Healthcare Provider Details

I. General information

NPI: 1811291909
Provider Name (Legal Business Name): SACRED HEART HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 MAIN ST
CREIGHTON NE
68729-2999
US

IV. Provider business mailing address

PO BOX 186
CREIGHTON NE
68729-0186
US

V. Phone/Fax

Practice location:
  • Phone: 402-358-5701
  • Fax: 402-358-5769
Mailing address:
  • Phone: 402-358-5700
  • 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: DOUGLAS EKEREN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 605-668-8321