Provider Demographics
NPI:1508157181
Name:PLUM CREEK CARE CENTER, INC.
Entity Type:Organization
Organization Name:PLUM CREEK CARE CENTER, INC.
Other - Org Name:WEL-LIFE AT PLUM CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-642-7736
Mailing Address - Street 1:1507 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-1243
Mailing Address - Country:US
Mailing Address - Phone:308-324-5531
Mailing Address - Fax:608-324-5630
Practice Address - Street 1:1507 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1243
Practice Address - Country:US
Practice Address - Phone:308-324-5531
Practice Address - Fax:608-324-5630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility