Provider Demographics
NPI:1003013293
Name:HIGHLAND HOUSE LLC
Entity Type:Organization
Organization Name:HIGHLAND HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:VANDERWERF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-589-0025
Mailing Address - Street 1:PO BOX 241
Mailing Address - Street 2:406 WEST VINTON STREET
Mailing Address - City:SPENCER
Mailing Address - State:NE
Mailing Address - Zip Code:68777
Mailing Address - Country:US
Mailing Address - Phone:402-589-0025
Mailing Address - Fax:402-589-0026
Practice Address - Street 1:406 WEST VINTON STREET
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:NE
Practice Address - Zip Code:68777
Practice Address - Country:US
Practice Address - Phone:402-589-0025
Practice Address - Fax:402-589-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility