Organization
GAHC3 BENNINGTON NE ALF TRS SUB, LLC
Active
Other names
Ridgewood Active Retirement Community
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY PROSKY (AUTHORIZED REPRESENTATIVE)
(949) 270-9200
Entity
Organization
Contact information
Practice address
12301 N 149TH CIR, BENNINGTON, NE 68007-5775
(402) 884-7644
(402) 884-8631
Mailing address
12301 N 149TH CIR, BENNINGTON, NE 68007-5775
(402) 884-7644
(402) 884-8631
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025948400
—
NE
Enumeration date
06/08/2015
Last updated
06/08/2015
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