Organization
COMPASSIONATE MEMORY CARE 1 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA KAY GRAPER (PRESIDENT)
(402) 699-3761
Entity
Organization
Contact information
Practice address
2402 N 102ND ST, OMAHA, NE 68134-5530
(402) 391-1499
(402) 391-9774
Mailing address
14805 DAYTON ST, OMAHA, NE 68137-5373
(402) 612-6789
(402) 894-1760
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
ALF317
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100255436-00
—
NE
Enumeration date
03/17/2011
Last updated
03/17/2011
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