Provider Demographics
NPI:1700561016
Name:GCA KEARNEY OPERATIONS
Entity Type:Organization
Organization Name:GCA KEARNEY OPERATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ORG DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-675-3925
Mailing Address - Street 1:560 1ST ST STE 104
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3273
Mailing Address - Country:US
Mailing Address - Phone:971-804-4195
Mailing Address - Fax:
Practice Address - Street 1:617 22ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2368
Practice Address - Country:US
Practice Address - Phone:308-856-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility