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General NPI Number Information
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NPI Number | 1346104114
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Entity Type | Organization
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Legal Business Name | MONUMENT HEALTHCARE AND NURSING CENTER LLC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 111 W 36TH ST
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-4636
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Country | US
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Telephone | 308-635-2019
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Fax |
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Provider Business Mailing Address
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Address Line | 325 PEMBROKE RD
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City | BALA CYNWYD
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State | PA
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Zip | 19004-2826
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED SIGNATORY
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Name | YEDIDYA KAGANOFF
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Credential |
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Telephone | 201-414-7854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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