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General NPI Number Information
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NPI Number | 1568929263
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Entity Type | Organization
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Legal Business Name | PEMBERLY PLACE MANAGEMENT, LLC
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 7655 ARCHER PL
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City | LINCOLN
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State | NE
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Zip | 68516-5286
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Country | US
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Telephone | 402-413-9770
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Fax |
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Provider Business Mailing Address
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Address Line | 7655 ARCHER PL
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City | LINCOLN
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State | NE
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Zip | 68516-5286
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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 | OWNER
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Name | MONTE FROEHLICH
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Credential |
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Telephone | 402-805-4136
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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 |
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License Number State |
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