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Organization

HILLCREST SHADOW LAKE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JOLENE ROBERTS (CEO/PRESIDENT)
(402) 682-4800
Entity
Organization

Contact information

Practice address
1507 E GOLD COAST RD, PAPILLION, NE 68046-4722
(402) 682-4800
Mailing address
1902 HARLAN DR, SUITE A, BELLEVUE, NE 68005-6609
(402) 682-4800

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026587800
NE
Enumeration date
05/06/2016
Last updated
01/25/2017
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