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Organization
KISMET OGA, LLC
Active
Organization
KISMET OGA, LLC
Active
Other names
Indian Hills Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOORE (CHIEF FINANCIAL OFFICER)
(605) 642-7736
Entity
Organization
Contact information
Practice address
1720 N SPRUCE ST, OGALLALA, NE 69153-3307
(308) 284-4068
(308) 284-8381
Mailing address
1720 N SPRUCE ST, OGALLALA, NE 69153-3307
(308) 284-4068
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
474001
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026754900
—
NE
Enumeration date
09/12/2005
Last updated
01/22/2019
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