# MADONNA REHABILITATION HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Jane de Chantal, St Jane de Chantal Long Term Care Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073605754
- **Authorized official:** MR. PAUL A. DONGILLI JR. (PRESIDENT & CEO)
- **Authorized official phone:** (402) 413-3000

## Contact information

- **Practice address:** 2200 S 52ND ST, LINCOLN, NE 68506-2030
- **Practice address phone:** (402) 413-3000
- **Practice address fax:** (402) 413-4113
- **Mailing address:** 5401 SOUTH ST, LINCOLN, NE 68506-2150
- **Mailing address phone:** (402) 413-3000
- **Mailing address fax:** (402) 413-4113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | LTCH022 | NE | — |
| 314000000X | Skilled Nursing Facility | LTCH022 | NE | Yes |

## Other

- **Enumeration date:** 09/29/2006
- **Last updated:** 09/10/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00210 | BLUE CROSS | NE |
| 01 | — | 0157020 | MEDICAID | SD |
| 01 | — | 0605267 | MEDICAID | IA |
| 01 | — | 100187780A | MEDICAID | KS |
| 01 | — | 112564800 | MEDICAID | WY |
| 01 | — | 5000016 | UNITEDHEALTHCARE | — |