Provider Demographics
NPI:1366453052
Name:VILLAGE OF BEEMER NEBRASKA
Entity Type:Organization
Organization Name:VILLAGE OF BEEMER NEBRASKA
Other - Org Name:COLONIA HAVEN DBA COLONIAL COURTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LIERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-528-3268
Mailing Address - Street 1:424 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BEEMER
Mailing Address - State:NE
Mailing Address - Zip Code:68716-4201
Mailing Address - Country:US
Mailing Address - Phone:402-528-3268
Mailing Address - Fax:
Practice Address - Street 1:424 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BEEMER
Practice Address - State:NE
Practice Address - Zip Code:68716-4201
Practice Address - Country:US
Practice Address - Phone:402-528-3268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF270310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========01Medicaid