Provider Demographics
NPI:1558641787
Name:GOLDEN LIVING CENTER-NELIGH
Entity Type:Organization
Organization Name:GOLDEN LIVING CENTER-NELIGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MPT
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:MOODY
Authorized Official - Last Name:WRAGGE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:402-649-2065
Mailing Address - Street 1:16 COTTONWOOD DRIVE
Mailing Address - Street 2:P O BOX 37
Mailing Address - City:NIOBRARA
Mailing Address - State:NE
Mailing Address - Zip Code:68760
Mailing Address - Country:US
Mailing Address - Phone:402-649-2065
Mailing Address - Fax:
Practice Address - Street 1:16 COTTONWOOD DR
Practice Address - Street 2:BOX 37
Practice Address - City:NIOBRARA
Practice Address - State:NE
Practice Address - Zip Code:68760-6083
Practice Address - Country:US
Practice Address - Phone:402-649-2065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1723314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility