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Organization

KISMET CDR, LLC

Active
Other names
Crest View Healthcare Community
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL MOORE (CHIEF FINANCIAL OFFICER)
(605) 642-7736
Entity
Organization

Contact information

Practice address
420 GORDON AVE, CHADRON, NE 69337-2006
(308) 432-3355
(308) 432-4335
Mailing address
420 GORDON AVE, CHADRON, NE 69337-2006
(308) 432-3355

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
214001
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026749400
NE
Enumeration date
07/14/2005
Last updated
01/22/2019
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