MEDICARE: LILIAN SARAY CHAVEZ

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	385HR2065X	Child Physical Disabilities Respite Care

General Provider Information

NPI Number	:	1700776150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIAN SARAY CHAVEZ

Provider Business Mailing Address
First Line	:	704 W 16TH ST
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68801-3516
Country	:	US
Telephone Number	:	308-383-3465
Fax Number	:

Provider Business Practice Location Address
First Line	:	4027 W CAPITAL AVE
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-1117
Country	:	US
Telephone Number	:	308-383-3465
Fax Number	:	308-383-3465

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	07/08/2025

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Directions to “ LILIAN SARAY CHAVEZ ” Practice Location

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