Healthcare Provider Details

I. General information

NPI: 1821736943
Provider Name (Legal Business Name): SENEX OF HEMINGFORD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/27/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 DONALD AVE
HEMINGFORD NE
69348-8205
US

IV. Provider business mailing address

3440 YOUNGFIELD ST # 358
WHEAT RIDGE CO
80033-5245
US

V. Phone/Fax

Practice location:
  • Phone: 308-487-3301
  • Fax:
Mailing address:
  • Phone: 308-487-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MITCHELL J FRIEDMAN
Title or Position: DIRECTOR OF OPS
Credential:
Phone: 303-641-2154