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General NPI Number Information
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NPI Number | 1881984599
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Entity Type | Organization
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Legal Business Name | WEL-LIFE AT PAPILLION, INC
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 801 N ADAMS ST
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City | PAPILLION
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State | NE
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Zip | 68046-4310
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Country | US
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Telephone | 402-339-1775
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Fax | 402-593-1915
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Provider Business Mailing Address
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Address Line | 801 N ADAMS ST
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City | PAPILLION
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State | NE
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Zip | 68046-4310
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Country | US
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Telephone | 402-339-1775
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Fax | 402-593-1915
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Authorized Official
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Title or Position | CFO
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Name | MR. MICHAEL L MOORE
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Credential |
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Telephone | 605-642-7736
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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 | 400176
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License Number State | NE
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