Provider Demographics
NPI:1861487696
Name:PLAINVIEW MANOR
Entity Type:Organization
Organization Name:PLAINVIEW MANOR
Other - Org Name:PLAINVIEW MANOR INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-582-3849
Mailing Address - Street 1:101 W HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NE
Mailing Address - Zip Code:68769-2037
Mailing Address - Country:US
Mailing Address - Phone:402-582-3849
Mailing Address - Fax:402-582-3850
Practice Address - Street 1:101 W HARPER AVE
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NE
Practice Address - Zip Code:68769-2037
Practice Address - Country:US
Practice Address - Phone:402-582-3849
Practice Address - Fax:402-582-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE624002314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE28E136OtherHHS FEDERAL
NE28E136Medicaid
NE28E136Medicaid
NE28E136OtherHHS FEDERAL