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Organization
CONVALESCENT PLACE
Active
Organization
CONVALESCENT PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANETTE L MOOBERRY (ADMINISTRATOR)
(402) 932-8053
Entity
Organization
Contact information
Practice address
2915 S 74TH ST, OMAHA, NE 68124-3519
(402) 932-8053
Mailing address
2915 S 74TH ST, OMAHA, NE 68124-3519
(402) 932-8053
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALF326
NE
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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