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General NPI Number Information
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NPI Number | 1922267624
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HEALTHCARE AND REHABILITATION CENTER
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 4735 S 54TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-1335
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Country | US
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Telephone | 402-488-0977
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Fax |
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Provider Business Mailing Address
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Address Line | 7800 S 34TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-4817
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Country | US
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Telephone | 402-499-1499
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | MRS. LYNN RENEE RATHBUN
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Credential | PTA
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Telephone | 402-499-1499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 330
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License Number State | NE
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