Organization
THE AMBASSADOR OMAHA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT B SHANHOLTZ (CHIEF FINANCIAL OFFICER)
(402) 873-8541
Entity
Organization
Contact information
Practice address
1540 N 72ND ST, OMAHA, NE 68114-1924
(402) 393-6500
Mailing address
1540 N 72ND ST, OMAHA, NE 68114-1924
(402) 873-8541
(402) 873-7244
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
264003
NE
225X00000X
Occupational Therapist
264003
NE
235Z00000X
Speech-Language Pathologist
264003
NE
314000000X
Skilled Nursing Facility
Primary
264003
NE
3140N1450X
Pediatric Skilled Nursing Facility
264003
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235010
—
SD
01
—
0517300002
DME
IA
01
—
0517300002
DME
NE
Enumeration date
07/29/2006
Last updated
08/17/2018
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