Provider Demographics
NPI:1629105358
Name:SUTTON COMMUNITY HOME INC
Entity Type:Organization
Organization Name:SUTTON COMMUNITY HOME INC
Other - Org Name:HILLCREST VIEW ASSISTED LIVING
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:D
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:HORST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-773-5557
Mailing Address - Street 1:1106 N SAUNDERS AVE
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:NE
Mailing Address - Zip Code:68979-2406
Mailing Address - Country:US
Mailing Address - Phone:402-773-5557
Mailing Address - Fax:402-773-5559
Practice Address - Street 1:205 W ADA ST
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:NE
Practice Address - Zip Code:68979-2520
Practice Address - Country:US
Practice Address - Phone:402-773-5557
Practice Address - Fax:402-773-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF235310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100250268Medicaid
28E156Medicare UPIN