Provider Demographics
NPI:1417431859
Name:PAWNEE CITY ASSISTED LIVING INC.
Entity Type:Organization
Organization Name:PAWNEE CITY ASSISTED LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:B
Authorized Official - Last Name:YUNGHANS
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:402-852-2055
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:
Mailing Address - City:PAWNEE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68420-0463
Mailing Address - Country:US
Mailing Address - Phone:402-852-2055
Mailing Address - Fax:402-852-2065
Practice Address - Street 1:330 12TH ST.
Practice Address - Street 2:
Practice Address - City:PAWNEE CITY
Practice Address - State:NE
Practice Address - Zip Code:68420-0463
Practice Address - Country:US
Practice Address - Phone:402-852-2055
Practice Address - Fax:402-852-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility