Organization
HILLCREST SHADOW LAKE, LLC
Active
Other names
Hillcrest Shadow Lake
Organization subpart
No
Provider details
NPI number
Authorized official
JOLENE L MATHISON ROBERTS (PRESIDENT)
(402) 682-4800
Entity
Organization
Contact information
Practice address
1507 E GOLD COAST RD, PAPILLION, NE 68046-4722
(402) 339-6010
Mailing address
1902 HARLAN DR STE A, BELLEVUE, NE 68005-6609
(402) 682-4201
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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