Healthcare Provider Details

I. General information

NPI: 1407762511
Provider Name (Legal Business Name): BLUE RIVER HEALTH AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 224TH
MILFORD NE
68405-8475
US

IV. Provider business mailing address

2100 W PLEASANT GROVE BLVD STE 160
PLEASANT GROVE UT
84062-3327
US

V. Phone/Fax

Practice location:
  • Phone: 385-498-0194
  • Fax:
Mailing address:
  • Phone:
  • 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: WENDY ANDERSON
Title or Position: CORPORATE BUSINESS OFFICER
Credential:
Phone: 385-498-0194