Provider Demographics
NPI:1306061817
Name:GREELEY CARE HOME & ASSISTED LIVING
Entity type:Organization
Organization Name:GREELEY CARE HOME & ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EINSPAHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-428-5145
Mailing Address - Street 1:201 E OCONNOR AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:NE
Mailing Address - Zip Code:68842-4215
Mailing Address - Country:US
Mailing Address - Phone:308-428-5145
Mailing Address - Fax:308-428-2013
Practice Address - Street 1:201 E OCONNOR AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:NE
Practice Address - Zip Code:68842-4215
Practice Address - Country:US
Practice Address - Phone:308-428-5145
Practice Address - Fax:308-428-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE364001302R00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid