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Organization

COUNTY OF LANCASTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD F. FETTERS (ADMINISTRATOR)
(402) 441-7101
Entity
Organization

Contact information

Practice address
1001 SOUTH ST, LINCOLN, NE 68502-2251
(402) 441-7101
(402) 441-6557
Mailing address
1001 SOUTH ST, LINCOLN, NE 68502-2251
(402) 441-7101
(402) 441-6557

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
504007
NE
314000000X
Skilled Nursing Facility
Primary
504007
NE

Other

Enumeration date
07/14/2006
Last updated
06/10/2008
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