# CONVALESCENT PLACE

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

## Provider details

- **NPI number:** 1982845871
- **Authorized official:** JANETTE L MOOBERRY (ADMINISTRATOR)
- **Authorized official phone:** (402) 932-8053

## Contact information

- **Practice address:** 2915 S 74TH ST, OMAHA, NE 68124-3519
- **Practice address phone:** (402) 932-8053
- **Mailing address:** 2915 S 74TH ST, OMAHA, NE 68124-3519
- **Mailing address phone:** (402) 932-8053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | ALF326 | NE | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 03/23/2009
- **Last updated:** 03/23/2009