Provider Demographics
NPI:1568751063
Name:SOUTHVIEW HEIGHTS
Entity Type:Organization
Organization Name:SOUTHVIEW HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RENNY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GRIGAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-714-5087
Mailing Address - Street 1:5110 S 49TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68117-2159
Mailing Address - Country:US
Mailing Address - Phone:402-731-2118
Mailing Address - Fax:402-733-2778
Practice Address - Street 1:5110 S 49TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68117-2159
Practice Address - Country:US
Practice Address - Phone:402-731-2118
Practice Address - Fax:402-733-2778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF161310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility