Healthcare Provider Details

I. General information

NPI: 1609780303
Provider Name (Legal Business Name): PAPILLION MABLE ROSE OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4609 HILLTOP ST
PAPILLION NE
68133-3323
US

IV. Provider business mailing address

4609 HILLTOP ST
PAPILLION NE
68133-3323
US

V. Phone/Fax

Practice location:
  • Phone: 917-745-7945
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: YOSEF EMANUEL
Title or Position: PRINCIPAL
Credential:
Phone: 917-745-7945