NPI | 1902860190 |
---|---|
Doing Business As | PONDEROSA VILLA |
Entity Type | Organization |
Authorized Contact | SANDRA J PERKINS Administrator 308-665-1224 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: NE 214002) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2008-07-31 |