Healthcare Provider Details
I. General information
NPI: 1740194943
Provider Name (Legal Business Name): GRETNA SILVER RIDGE OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20322 HACKBERRY DR
GRETNA NE
68028
US
IV. Provider business mailing address
20322 HACKBERRY DR
GRETNA NE
68028
US
V. Phone/Fax
- Phone: 917-745-7945
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
YOSEF
EMANUEL
Title or Position: PRINCIPAL
Credential:
Phone: 917-745-7945