Healthcare Provider Details

I. General information

NPI: 1649285578
Provider Name (Legal Business Name): THE AMBASSADOR REHAB & WELLNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 N 19TH ST STE # 2
NEBRASKA CITY NE
68410-1119
US

IV. Provider business mailing address

1240 N 19TH ST STE # 2
NEBRASKA CITY NE
68410-1119
US

V. Phone/Fax

Practice location:
  • Phone: 402-873-4838
  • Fax: 402-873-4117
Mailing address:
  • Phone: 402-873-4838
  • Fax: 402-873-4117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY J JUILFS
Title or Position: PRESIDENT - OWNER
Credential:
Phone: 402-873-7791