Basic Information
| Provider Information | |||||||||
| NPI: | 1891804308 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUALITY LIVING, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6404 NORTH 70TH PLAZA | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025733700 | ||||||||
| FaxNumber: | 4025733780 | ||||||||
| Practice Location | |||||||||
| Address1: | 6404 NORTH 70TH PLAZA | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025733700 | ||||||||
| FaxNumber: | 4025733790 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 08/12/2009 | ||||||||
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| AuthorizedOfficialLastName: | SCHUITEMAN | ||||||||
| AuthorizedOfficialFirstName: | TODD | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT & CFO | ||||||||
| AuthorizedOfficialTelephone: | 4025733744 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | HHA1002 | NE | N | Agencies | Home Health | 310400000X | ALF | NE | N | Nursing & Custodial Care Facilities | Assisted Living Facility | 313M00000X | 264014 | NE | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
ID Information
| ID | Type | State | Issuer | Description | 0157350 | 05 | SD | MEDICAID | 00789 | 01 | NE | BLUE CROSS BLUE SHIELD OF | OTHER | 0659888 | 05 | IA | MEDICAID | 00788 | 01 | NE | BLUE CROSS BLUE SHIELD OF | OTHER | 0650259 | 05 | IA | MEDICAID |