Organization
GAHC3 OMAHA NE ALF TRS SUB, LLC
Active
Other names
Fountain View Assisted Living and Special Memory Care
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY PROSKY (AUTHORIZED REPRESENTATIVE)
(949) 270-9200
Entity
Organization
Contact information
Practice address
5710 S 108TH ST, OMAHA, NE 68137-3592
(402) 596-9033
Mailing address
5710 S 108TH ST, OMAHA, NE 68137-3592
(402) 596-9033
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253886-00
—
NE
Enumeration date
06/08/2015
Last updated
06/08/2015
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