Healthcare Provider Details

I. General information

NPI: 1598712200
Provider Name (Legal Business Name): BEVERLY ENTERPRISES - NEBRASKA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W MEIGS ST
VALLEY NE
68064-9758
US

IV. Provider business mailing address

300 W MEIGS ST
VALLEY NE
68064-9758
US

V. Phone/Fax

Practice location:
  • Phone: 402-359-2533
  • Fax:
Mailing address:
  • Phone: 402-359-2533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier478
Identifier TypeOTHER
Identifier StateNE
Identifier IssuerBCBS
# 2
IdentifierF247536
Identifier TypeOTHER
Identifier StateNE
Identifier IssuerMIDLANDS CHOICE

VIII. Authorized Official

Name: HOLLY A RASMUSSEN-JONES
Title or Position: SECRETARY
Credential:
Phone: 479-201-4835