Provider Demographics
NPI:1346364536
Name:LOUISVILLE CARE CENTER
Entity Type:Organization
Organization Name:LOUISVILLE CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:308-379-9328
Mailing Address - Street 1:6915 WRIGHT PLZ
Mailing Address - Street 2:APT # L8
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3400
Mailing Address - Country:US
Mailing Address - Phone:308-379-9328
Mailing Address - Fax:
Practice Address - Street 1:410 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:NE
Practice Address - Zip Code:68037-6006
Practice Address - Country:US
Practice Address - Phone:402-234-2125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1255314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility