Provider Demographics
NPI:1821615709
Name:HOMESTEAD SNF OPERATIONS LLC
Entity Type:Organization
Organization Name:HOMESTEAD SNF OPERATIONS LLC
Other - Org Name:BROOKSIDE REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/COO
Authorized Official - Prefix:MS
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-488-0977
Mailing Address - Street 1:1195 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2316
Mailing Address - Country:US
Mailing Address - Phone:516-855-5504
Mailing Address - Fax:
Practice Address - Street 1:4735 S 54TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1398
Practice Address - Country:US
Practice Address - Phone:402-488-0977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility