Provider Demographics
NPI:1619314325
Name:SENEX FOUNDATION OF NEBRASKA, INC
Entity Type:Organization
Organization Name:SENEX FOUNDATION OF NEBRASKA, INC
Other - Org Name:SKYVIEW CARE AND REHAB AT BRIDGEPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-929-0086
Mailing Address - Street 1:3440 YOUNGFIELD ST STE 358
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5245
Mailing Address - Country:US
Mailing Address - Phone:720-929-0086
Mailing Address - Fax:720-929-0381
Practice Address - Street 1:505 O ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:NE
Practice Address - Zip Code:69336-4045
Practice Address - Country:US
Practice Address - Phone:720-929-0086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE285224Medicare Oscar/Certification