Provider Demographics
NPI:1821736943
Name:SENEX OF HEMINGFORD, LLC
Entity Type:Organization
Organization Name:SENEX OF HEMINGFORD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPS
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-641-2154
Mailing Address - Street 1:3440 YOUNGFIELD ST # 358
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-5245
Mailing Address - Country:US
Mailing Address - Phone:308-487-3301
Mailing Address - Fax:
Practice Address - Street 1:605 DONALD AVE
Practice Address - Street 2:
Practice Address - City:HEMINGFORD
Practice Address - State:NE
Practice Address - Zip Code:69348-8205
Practice Address - Country:US
Practice Address - Phone:308-487-3301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility