Organization
KISMET OGA, LLC
Active
Other names
Indian Hills Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOORE (CHIEF FINANCIAL OFFICER)
(605) 642-7736
Entity
Organization
Contact information
Practice address
1720 N SPRUCE ST, OGALLALA, NE 69153-3307
(308) 284-4068
(308) 284-8381
Mailing address
1720 N SPRUCE ST, OGALLALA, NE 69153-3307
(308) 284-4068
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
474001
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026754900
—
NE
Enumeration date
09/12/2005
Last updated
01/22/2019
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