# PREMIER ESTATES OF PAWNEE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497132237
- **Authorized official:** GREGORY SHAYNE BENCH (CFO)
- **Authorized official phone:** (941) 758-4745

## Contact information

- **Practice address:** 438 12TH ST, PAWNEE CITY, NE 68420-3589
- **Practice address phone:** (402) 852-2975
- **Practice address fax:** (402) 852-2979
- **Mailing address:** 5265 OFFICE PARK BLVD, SUITE 101, BRADENTON, FL 34203-3441
- **Mailing address phone:** (941) 758-4745
- **Mailing address fax:** (941) 751-2135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 04/30/2015
- **Last updated:** 10/10/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100265081-00 | — | NE |