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NPI Code Detail

MEDICARE: MARQUIS PLACE OF ELKHORN LLC

MEDICARE: MARQUIS PLACE OF ELKHORN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityALF220NE

General Provider Information

NPI Number : 1508075029
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARQUIS PLACE OF ELKHORN LLC
Provider Business Mailing Address
First Line : 20800 W MAPLE RD
Second Line :
City : ELKHORN
State : NE
Zip : 68022-5108
Country : US
Telephone Number : 402-289-9229
Fax Number :
Provider Business Practice Location Address
First Line : 20800 W MAPLE RD
Second Line :
City : ELKHORN
State : NE
Zip : 68022-5108
Country : US
Telephone Number : 402-289-9229
Fax Number :
Authorized Official
Title or Position : PRESIDENT OWNER
Name : MR. BRIAN WARREN
Credential :
Telephone Number : 316-733-1144
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/27/2007

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Directions to “MARQUIS PLACE OF ELKHORN LLC ” Practice Location

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