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General NPI Number Information
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NPI Number | 1396038758
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Entity Type | Organization
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Legal Business Name | PRAIRIE INVESTORS, L.L.C.
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 450 S MAIN ST
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City | AINSWORTH
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State | NE
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Zip | 69210-1701
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Country | US
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Telephone | 402-387-1000
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Fax | 402-387-1015
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Provider Business Mailing Address
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Address Line | 450 S MAIN ST
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City | AINSWORTH
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State | NE
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Zip | 69210-1701
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Country | US
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Telephone | 402-387-1000
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Fax | 402-387-1015
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANN F. FIALA
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Credential |
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Telephone | 402-387-1000
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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 | ALF046
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License Number State | NE
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