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General NPI Number Information
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NPI Number | 1457644577
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Entity Type | Organization
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Legal Business Name | SENECA SUNRISE LLC
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Dates
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Enumeration Date | 05/23/2011
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 710 GRAND AVE
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City | RAVENNA
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State | NE
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Zip | 68869-1100
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Country | US
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Telephone | 308-452-7100
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Fax | 308-452-7214
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Provider Business Mailing Address
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Address Line | 710 GRAND AVE
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City | RAVENNA
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State | NE
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Zip | 68869-1100
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Country | US
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Telephone | 308-452-7100
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Fax | 308-452-7214
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LINDA S ZINNELL
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Credential |
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Telephone | 308-452-7100
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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 | ALF200
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License Number State | NE
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