Provider Demographics
NPI:1467743021
Name:THE KENSINGTON HASTINGS LLC
Entity Type:Organization
Organization Name:THE KENSINGTON HASTINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRECKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-461-3149
Mailing Address - Street 1:233 N HASTINGS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5168
Mailing Address - Country:US
Mailing Address - Phone:402-461-3149
Mailing Address - Fax:402-461-4513
Practice Address - Street 1:233 N HASTINGS AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5168
Practice Address - Country:US
Practice Address - Phone:402-461-3149
Practice Address - Fax:402-461-4513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGEMARK CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF239310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100250918/00Medicaid