Organization
CITY OF CRAWFORD
Active
Other names
Ponderosa Villa
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA J PERKINS (ADMINISTRATOR)
(308) 665-1224
Entity
Organization
Contact information
Practice address
1ST & PADDOCK, CRAWFORD, NE 69339
(308) 665-1224
(308) 665-2450
Mailing address
PO BOX 526, 1ST & PADDOCK, CRAWFORD, NE 69339
(308) 665-1224
(308) 665-2450
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
214002
NE
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060034
BLUE CROSS BLUE SHIELD
NE
Enumeration date
04/14/2006
Last updated
07/31/2008
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