Healthcare Provider Details

I. General information

NPI: 1538256078
Provider Name (Legal Business Name): MADONNA REHABILITATION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 12/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 SOUTH ST
LINCOLN NE
68506-2150
US

IV. Provider business mailing address

5401 SOUTH ST
LINCOLN NE
68506-2150
US

V. Phone/Fax

Practice location:
  • Phone: 402-413-3000
  • Fax: 402-413-4113
Mailing address:
  • Phone: 402-413-3000
  • Fax: 402-413-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number507001
License Number StateNE

VIII. Authorized Official

Name: MR. PAUL A. DONGILLI JR.
Title or Position: PRESIDENT & CEO
Credential:
Phone: 402-413-3000