Provider Demographics
NPI:1932220241
Name:HEMINGFORD COMMUNITY CARE CENTER
Entity Type:Organization
Organization Name:HEMINGFORD COMMUNITY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-487-3301
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:605 DONALD AVE.
Mailing Address - City:HEMINGFORD
Mailing Address - State:NE
Mailing Address - Zip Code:69348-0307
Mailing Address - Country:US
Mailing Address - Phone:308-487-3301
Mailing Address - Fax:308-487-5447
Practice Address - Street 1:605 DONALD AVE.
Practice Address - Street 2:
Practice Address - City:HEMINGFORD
Practice Address - State:NE
Practice Address - Zip Code:69348-0307
Practice Address - Country:US
Practice Address - Phone:308-487-3301
Practice Address - Fax:308-487-5447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE044003314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47600622500Medicaid
NE=========00Medicaid
NE=========00Medicaid