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General NPI Number Information
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NPI Number | 1598968372
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Entity Type | Organization
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Legal Business Name | PAWNEE ASSISTED LIVING
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/01/2011
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Provider Practice Location Address
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Address Line | 221 E 5TH ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6918
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Country | US
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Telephone | 308-532-6600
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Fax | 308-532-9644
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Provider Business Mailing Address
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Address Line | 221 E 5TH ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6918
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Country | US
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Telephone | 308-532-6600
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Fax | 308-532-9644
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SANDRA J SCHADE
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Credential |
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Telephone | 308-532-6600
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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 | 515005
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License Number State | NE
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