Provider Demographics
NPI:1326268418
Name:FIVE STAR QUALITY CARE - NE, LLC DBA AINSWORTH CARE CENTER
Entity Type:Organization
Organization Name:FIVE STAR QUALITY CARE - NE, LLC DBA AINSWORTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SYFIE
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:402-387-2500
Mailing Address - Street 1:143 N FULLERTON ST
Mailing Address - Street 2:
Mailing Address - City:AINSWORTH
Mailing Address - State:NE
Mailing Address - Zip Code:69210-1515
Mailing Address - Country:US
Mailing Address - Phone:402-387-2500
Mailing Address - Fax:
Practice Address - Street 1:143 N FULLERTON ST
Practice Address - Street 2:
Practice Address - City:AINSWORTH
Practice Address - State:NE
Practice Address - Zip Code:69210-1515
Practice Address - Country:US
Practice Address - Phone:402-387-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100249953-00Medicaid
NE100249953-00Medicaid
NE=========08Medicaid