=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215431192
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOPE COOPERATIVE CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2018
-----------------------------------------------------
Last Update Date | 12/19/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 324 N 5TH ST
-----------------------------------------------------
City | PLATTSMOUTH
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68048-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-298-4140
-----------------------------------------------------
Fax | 402-298-4582
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 324 N 5TH ST
-----------------------------------------------------
City | PLATTSMOUTH
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68048-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-298-4140
-----------------------------------------------------
Fax | 402-298-4582
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SARAH CAMPBELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-298-4140
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | 370
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------