Provider Demographics
NPI:1598712200
Name:BEVERLY ENTERPRISES - NEBRASKA INC
Entity Type:Organization
Organization Name:BEVERLY ENTERPRISES - NEBRASKA INC
Other - Org Name:GOLDEN LIVINGCENTER - VALHAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-201-4835
Mailing Address - Street 1:300 W MEIGS ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:NE
Mailing Address - Zip Code:68064-9758
Mailing Address - Country:US
Mailing Address - Phone:402-359-2533
Mailing Address - Fax:
Practice Address - Street 1:300 W MEIGS ST
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:NE
Practice Address - Zip Code:68064-9758
Practice Address - Country:US
Practice Address - Phone:402-359-2533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEVERLY HEALTH AND REHABILITATION SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-28
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE478OtherBCBS
NEF247536OtherMIDLANDS CHOICE
NE=========22Medicaid
NE285117Medicare Oscar/Certification
NEF247536OtherMIDLANDS CHOICE