Provider Demographics
NPI:1679740351
Name:HAMILTON COUNTY HOME FOR THE AGED
Entity Type:Organization
Organization Name:HAMILTON COUNTY HOME FOR THE AGED
Other - Org Name:HAMILTON MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA CDP
Authorized Official - Phone:402-694-2128
Mailing Address - Street 1:1515 5TH ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818
Mailing Address - Country:US
Mailing Address - Phone:402-694-2128
Mailing Address - Fax:402-694-2403
Practice Address - Street 1:1515 5TH ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818
Practice Address - Country:US
Practice Address - Phone:402-694-2128
Practice Address - Fax:402-694-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE285263332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid
285263Medicare Oscar/Certification