Provider Demographics
NPI:1629560446
Name:VSL ALLIANCE ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:VSL ALLIANCE ASSISTED LIVING LLC
Other - Org Name:HIGHLAND PARK ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-885-6120
Mailing Address - Street 1:150 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-2156
Mailing Address - Country:US
Mailing Address - Phone:308-762-1615
Mailing Address - Fax:308-762-1621
Practice Address - Street 1:150 W 24TH ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301
Practice Address - Country:US
Practice Address - Phone:308-762-1615
Practice Address - Fax:308-762-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF048310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility