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General NPI Number Information
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NPI Number | 1154601078
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Entity Type | Organization
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Legal Business Name | HAVEN MANOR ASSISTED LIVING PLUS
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Dates
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Enumeration Date | 08/23/2011
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 4800 S 48TH ST COLLEGE VIEW NORTH
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City | LINCOLN
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State | NE
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Zip | 68516-1216
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Country | US
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Telephone | 402-434-2680
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 S 48TH ST COLLEGE VIEW NORTH
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City | LINCOLN
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State | NE
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Zip | 68516-1216
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Country | US
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Telephone | 402-434-2680
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Fax |
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Authorized Official
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Title or Position | ACCOUNTING DEPT
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Name | SAMANTHA D ULERY
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Credential |
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Telephone | 402-434-2680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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