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NPI Code Detail

MEDICARE: THE INDEPENDENCE HOUSE CODDINGTON

MEDICARE: THE INDEPENDENCE HOUSE CODDINGTON
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
1311500000XAlzheimer Center (Dementia Center)ALF312NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528362027
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE INDEPENDENCE HOUSE CODDINGTON
Provider Business Mailing Address
First Line : 1609 N ST
Second Line :
City : LINCOLN
State : NE
Zip : 68508-1884
Country : US
Telephone Number : 402-475-7755
Fax Number : 402-474-2391
Provider Business Practice Location Address
First Line : 5500 S CODDINGTON AVE
Second Line :
City : LINCOLN
State : NE
Zip : 68523-9152
Country : US
Telephone Number : 402-420-0329
Fax Number : 888-593-1114
Authorized Official
Title or Position : PRESIDENT
Name : MS. MARSHA E. STORK
Credential :
Telephone Number : 402-475-7755
Provider Enumeration Date : 12/27/2010
Last Update Date : 11/26/2012

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Directions to “THE INDEPENDENCE HOUSE CODDINGTON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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