Healthcare Provider Details

I. General information

NPI: 1689669756
Provider Name (Legal Business Name): ELWOOD CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 SMITH AVE
ELWOOD NE
68937-5236
US

IV. Provider business mailing address

PO BOX 315
ELWOOD NE
68937-0315
US

V. Phone/Fax

Practice location:
  • Phone: 308-785-3302
  • Fax: 308-785-3193
Mailing address:
  • Phone: 308-785-3302
  • Fax: 308-785-3193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number354001
License Number StateNE

VIII. Authorized Official

Name: MRS. KATE M. REINERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 308-785-3302