Basic Information
| Provider Information | |||||||||
| NPI: | 1083161012 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLUMBUS CARE AND REHABILITATION CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 625 | ||||||||
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| City: | COLUMBUS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 686020625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025648014 | ||||||||
| FaxNumber: | 4025640885 | ||||||||
| Practice Location | |||||||||
| Address1: | 2855 40TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | NE | ||||||||
| PostalCode: | 686012152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025648014 | ||||||||
| FaxNumber: | 4025640885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2016 | ||||||||
| LastUpdateDate: | 04/18/2017 | ||||||||
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| AuthorizedOfficialLastName: | SCHWARTZ | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2016351195 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | N | Nursing & Custodial Care Facilities | Assisted Living Facility | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 235Z00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 225X00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 315D00000X | N | Nursing & Custodial Care Facilities | Hospice, Inpatient | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.