Organization
WAUSA LEISURE LIVING, LLC
Active
Other names
Countryside Villa
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEAN M HOLCOMB (ADMINISTRATOR)
(402) 586-2890
Entity
Organization
Contact information
Practice address
803 S VIVIAN ST, WAUSA, NE 68786-2046
(402) 586-2890
(402) 586-2945
Mailing address
803 S VIVIAN ST, WAUSA, NE 68786-2046
(402) 586-2890
(402) 586-2945
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALF232
NE
Other
Enumeration date
11/20/2006
Last updated
08/22/2020
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