Organization
IMMANUEL LONG TERM CARE
Active
Other names
The Lighthouse at Lakeside Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC N GURLEY (PRESIDENT AND CEO)
(402) 829-2900
Entity
Organization
Contact information
Practice address
17600 ARBOR ST, OMAHA, NE 68130-4682
(402) 829-9070
(402) 829-9071
Mailing address
1044 N 115TH ST STE 500, OMAHA, NE 68154-4410
(402) 829-2931
(402) 829-2939
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/12/2013
Last updated
05/30/2019
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