Healthcare Provider Details

I. General information

NPI: 1932600038
Provider Name (Legal Business Name): SHILOH CENTER ADULT DAY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E MILITARY AVE
FREMONT NE
68025-5066
US

IV. Provider business mailing address

114 E MILITARY AVE
FREMONT NE
68025-5066
US

V. Phone/Fax

Practice location:
  • Phone: 402-208-8859
  • Fax: 402-721-9170
Mailing address:
  • Phone: 402-208-8859
  • Fax: 402-721-9170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA WHITTEN
Title or Position: MANAGING MEMBER
Credential:
Phone: 402-208-8859