Healthcare Provider Details

I. General information

NPI: 1932220241
Provider Name (Legal Business Name): HEMINGFORD COMMUNITY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 DONALD AVE.
HEMINGFORD NE
69348-0307
US

IV. Provider business mailing address

PO BOX 307 605 DONALD AVE.
HEMINGFORD NE
69348-0307
US

V. Phone/Fax

Practice location:
  • Phone: 308-487-3301
  • Fax: 308-487-5447
Mailing address:
  • Phone: 308-487-3301
  • Fax: 308-487-5447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number044003
License Number StateNE

VIII. Authorized Official

Name: LANA LEE TAYLOR
Title or Position: ADMINISTRATOR
Credential:
Phone: 308-487-3301