Organization
CCLIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA MARIE SAUTTER (ADMINISTRATOR)
(308) 946-2276
Entity
Organization
Contact information
Practice address
1307 16TH ST, CENTRAL CITY, NE 68826-1809
(308) 946-2276
(308) 946-9887
Mailing address
1307 16TH ST, CENTRAL CITY, NE 68826-1809
(308) 946-2276
(308) 946-9887
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04630562
—
NE
Enumeration date
04/24/2019
Last updated
04/24/2019
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