Organization
PREMIER ESTATES OF CRETE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY SHAYNE BENCH (CFO)
(941) 758-4745
Entity
Organization
Contact information
Practice address
830 E 1ST ST, CRETE, NE 68333-3108
(402) 826-4325
(402) 826-4654
Mailing address
5265 OFFICE PARK BLVD, SUITE 101, BRADENTON, FL 34203-3441
(941) 758-4745
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100265077-00
—
NE
Enumeration date
03/05/2015
Last updated
10/14/2015
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