Provider Demographics
NPI:1063007763
Name:SJV 2 OMAHA OPCO LLC
Entity Type:Organization
Organization Name:SJV 2 OMAHA OPCO LLC
Other - Org Name:BRIGHTON GARDENS OF OMAHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEISHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-393-7313
Mailing Address - Street 1:9220 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2297
Mailing Address - Country:US
Mailing Address - Phone:402-393-7313
Mailing Address - Fax:402-393-7340
Practice Address - Street 1:9220 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2297
Practice Address - Country:US
Practice Address - Phone:402-393-7313
Practice Address - Fax:402-393-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility