Healthcare Provider Details

I. General information

NPI: 1770571606
Provider Name (Legal Business Name): BLUE VALLEY LUTHERAN HOMES SOCIETY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S 3RD ST
HEBRON NE
68370-2000
US

IV. Provider business mailing address

PO BOX 166
HEBRON NE
68370-0166
US

V. Phone/Fax

Practice location:
  • Phone: 402-768-3900
  • Fax: 402-768-3901
Mailing address:
  • Phone: 402-768-3900
  • Fax: 402-768-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StateNE

VIII. Authorized Official

Name: MR. LYLE HIGHT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 402-768-3900