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NPI Code Detail

MEDICARE: CELEBRATE LIFE, INC.

MEDICARE: CELEBRATE LIFE, INC.
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
1314000000XSkilled Nursing Facility254005NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
160003OTHERNEBCBS OF NEBRASKA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558368050
Entity Type Code : Organization
Provider Name (Legal Business Name) : CELEBRATE LIFE, INC.
Provider Business Mailing Address
First Line : 1120 WALNUT ST
Second Line :
City : NORTH BEND
State : NE
Zip : 68649-5012
Country : US
Telephone Number : 402-652-3242
Fax Number : 402-652-3547
Provider Business Practice Location Address
First Line : 1120 WALNUT ST
Second Line :
City : NORTH BEND
State : NE
Zip : 68649-5012
Country : US
Telephone Number : 402-652-3242
Fax Number : 402-652-3547
Authorized Official
Title or Position : PRESIDENT
Name : MS. PAMELA SUE GRIFFIN
Credential :
Telephone Number : 402-652-3242
Provider Enumeration Date : 06/30/2005
Last Update Date : 08/22/2020

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