Provider Demographics
NPI:1689712952
Name:CITY OF MITCHELL
Entity Type:Organization
Organization Name:CITY OF MITCHELL
Other - Org Name:MITCHELL CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-623-1212
Mailing Address - Street 1:1723 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:NE
Mailing Address - Zip Code:69357-1000
Mailing Address - Country:US
Mailing Address - Phone:308-623-1212
Mailing Address - Fax:308-623-2052
Practice Address - Street 1:1723 23RD ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:NE
Practice Address - Zip Code:69357
Practice Address - Country:US
Practice Address - Phone:308-623-1212
Practice Address - Fax:308-623-2052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF MITCHELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-01
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF266310400000X
NE704003314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE28E246Medicaid
285287Medicare Oscar/Certification