Healthcare Provider Details

I. General information

NPI: 1023972957
Provider Name (Legal Business Name): SOUTHERLAND OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 MAPLE ST
SUTHERLAND NE
69165-3000
US

IV. Provider business mailing address

333 MAPLE ST
SUTHERLAND NE
69165-3000
US

V. Phone/Fax

Practice location:
  • Phone: 308-692-3100
  • Fax:
Mailing address:
  • Phone: 308-692-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM SMILOW
Title or Position: REGIONAL DIRECTOR OF OPERATIONS
Credential:
Phone: 917-543-4391