MEDICARE: FLORENCE HOME FOR THE AGED

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
1	314000000X	Skilled Nursing Facility	264005	NE

General Provider Information

NPI Number	:	1518966308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORENCE HOME FOR THE AGED

Provider Business Mailing Address
First Line	:	7915 N 30TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-2418
Country	:	US
Telephone Number	:	402-827-6000
Fax Number	:	402-827-6005

Provider Business Practice Location Address
First Line	:	7915 N 30TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68112-2418
Country	:	US
Telephone Number	:	402-827-6000
Fax Number	:	402-827-6005

Authorized Official
Title or Position	:	CFO
Name	:	DEBRA L THACKER
Credential	:
Telephone Number	:	402-827-6000

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	04/24/2015

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Directions to “FLORENCE HOME FOR THE AGED ” Practice Location

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