Provider Demographics
NPI:1891026530
Name:LANCASTER MANOR REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:LANCASTER MANOR REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-905-4000
Mailing Address - Street 1:1001 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2251
Mailing Address - Country:US
Mailing Address - Phone:402-441-7101
Mailing Address - Fax:402-441-6557
Practice Address - Street 1:1001 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2251
Practice Address - Country:US
Practice Address - Phone:402-441-7101
Practice Address - Fax:402-441-6557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE504007313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE504007Medicaid
NE28-5275Medicare PIN