Provider Demographics
NPI:1740571173
Name:WEL-LIFE AT KEARNEY, INC
Entity type:Organization
Organization Name:WEL-LIFE AT KEARNEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-642-7736
Mailing Address - Street 1:5616 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2890
Mailing Address - Country:US
Mailing Address - Phone:308-234-9905
Mailing Address - Fax:308-237-3886
Practice Address - Street 1:5616 4TH AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2890
Practice Address - Country:US
Practice Address - Phone:308-234-9905
Practice Address - Fax:308-237-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility