Provider Demographics
NPI:1851006209
Name:SRMC LONG TERM CARE LLC
Entity Type:Organization
Organization Name:SRMC LONG TERM CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:UTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-254-5825
Mailing Address - Street 1:1000 POLE CREEK XING
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-2901
Mailing Address - Country:US
Mailing Address - Phone:308-254-5825
Mailing Address - Fax:
Practice Address - Street 1:549 KELLER DR
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-1775
Practice Address - Country:US
Practice Address - Phone:308-254-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility