Healthcare Provider Details

I. General information

NPI: 1376991752
Provider Name (Legal Business Name): MADONNA REHABILITATION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17500 BURKE ST
OMAHA NE
68118-2244
US

IV. Provider business mailing address

5401 SOUTH ST
LINCOLN NE
68506-2150
US

V. Phone/Fax

Practice location:
  • Phone: 402-401-3100
  • Fax: 402-401-5118
Mailing address:
  • Phone: 402-413-3000
  • Fax: 402-413-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

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