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Organization
MIDWEST COVENANT HOME, INC.
Active
Organization
MIDWEST COVENANT HOME, INC.
Active
Other names
Midwest Covenant Home, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER M YOUNG (ADMINISTRATOR)
(402) 764-2711
Entity
Organization
Contact information
Practice address
615 E 9TH ST, STROMSBURG, NE 68666-4053
(402) 764-2711
(402) 764-4352
Mailing address
615 E 9TH ST, PO BOX 367, STROMSBURG, NE 68666-4053
(402) 764-2711
(402) 764-4352
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
644002
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00526
BLUE CROSS BLUE SHIELD
—
01
—
0640750001
DMERC
—
01
—
F249543
TEAMCARE
—
Enumeration date
07/19/2005
Last updated
04/12/2016
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