Healthcare Provider Details

I. General information

NPI: 1558368050
Provider Name (Legal Business Name): CELEBRATE LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 WALNUT ST
NORTH BEND NE
68649-5012
US

IV. Provider business mailing address

1120 WALNUT ST
NORTH BEND NE
68649-5012
US

V. Phone/Fax

Practice location:
  • Phone: 402-652-3242
  • Fax: 402-652-3547
Mailing address:
  • Phone: 402-652-3242
  • Fax: 402-652-3547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number254005
License Number StateNE

VIII. Authorized Official

Name: MS. PAMELA SUE GRIFFIN
Title or Position: PRESIDENT
Credential:
Phone: 402-652-3242