Healthcare Provider Details

I. General information

NPI: 1174586705
Provider Name (Legal Business Name): NORTH PLATTE CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W E ST
NORTH PLATTE NE
69101-1803
US

IV. Provider business mailing address

11523 PALMBRUSH TRL SUITE 331
LAKEWOOD RANCH FL
34202-2917
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-2200
  • Fax: 308-534-9069
Mailing address:
  • Phone: 941-758-4745
  • Fax: 888-391-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number514003
License Number StateNE

VIII. Authorized Official

Name: MR. GREGORY S BENCH
Title or Position: PRESIDENT
Credential:
Phone: 941-758-4745