Provider Demographics
NPI:1417240573
Name:L'KAD'S SENIOR LIVING DEVELOPMENT,LLC ST
Entity Type:Organization
Organization Name:L'KAD'S SENIOR LIVING DEVELOPMENT,LLC ST
Other - Org Name:SENIOR LIVING CHOICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRULL
Authorized Official - Suffix:
Authorized Official - Credentials:VETERINARIAN
Authorized Official - Phone:308-367-5463
Mailing Address - Street 1:217 CROOK AVE
Mailing Address - Street 2:
Mailing Address - City:CURTIS
Mailing Address - State:NE
Mailing Address - Zip Code:69025-9531
Mailing Address - Country:US
Mailing Address - Phone:308-367-4253
Mailing Address - Fax:308-367-4387
Practice Address - Street 1:217 CROOK AVE
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:NE
Practice Address - Zip Code:69025-9531
Practice Address - Country:US
Practice Address - Phone:308-367-4253
Practice Address - Fax:308-367-4387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF212310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility