Healthcare Provider Details

I. General information

NPI: 1275063802
Provider Name (Legal Business Name): VSL PAPILLION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S POLK ST
PAPILLION NE
68046-2548
US

IV. Provider business mailing address

20220 HARNEY ST
ELKHORN NE
68022-2063
US

V. Phone/Fax

Practice location:
  • Phone: 402-339-7700
  • Fax: 402-592-9155
Mailing address:
  • Phone: 402-885-6120
  • Fax: 402-895-8165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number684004
License Number StateNE

VIII. Authorized Official

Name: JACK D VETTER
Title or Position: CEO
Credential:
Phone: 402-895-3932