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General NPI Number Information
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NPI Number | 1548564552
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Entity Type | Organization
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Legal Business Name | LEGACY ESTATES MANAGEMENT, LP
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 7200 VAN DORN ST
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City | LINCOLN
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State | NE
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Zip | 68506-3716
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Country | US
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Telephone | 402-484-8888
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Fax | 402-484-3859
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Provider Business Mailing Address
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Address Line | 7200 VAN DORN ST
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City | LINCOLN
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State | NE
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Zip | 68506-3716
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Country | US
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Telephone | 402-484-8888
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Fax | 402-484-3859
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JAY BOHLKEN
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Credential |
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Telephone | 402-484-8888
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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 | ALF282
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License Number State | NE
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