Provider Demographics
NPI:1881976447
Name:SILVERCREST ELK RIDGE ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:SILVERCREST ELK RIDGE ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-763-8692
Mailing Address - Street 1:19400 ELK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-3074
Mailing Address - Country:US
Mailing Address - Phone:402-763-8692
Mailing Address - Fax:
Practice Address - Street 1:19400 ELK RIDGE DR
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3074
Practice Address - Country:US
Practice Address - Phone:402-763-8692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF314310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility