Provider Demographics
NPI:1942391057
Name:NORTHFIELD RETIREMENT COMMUNITIES
Entity Type:Organization
Organization Name:NORTHFIELD RETIREMENT COMMUNITIES
Other - Org Name:NORTHFIELD RETIREMENT COMMUNITIES CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CAO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:308-632-4342
Mailing Address - Street 1:2100 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1893
Mailing Address - Country:US
Mailing Address - Phone:308-632-4342
Mailing Address - Fax:308-630-8190
Practice Address - Street 1:2100 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1893
Practice Address - Country:US
Practice Address - Phone:308-632-4342
Practice Address - Fax:308-630-8190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHFIELD RETIREMENT COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-27
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE704004314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025386500Medicaid
NE285271Medicare Oscar/Certification