Provider Demographics
NPI:1487076790
Name:SNF OMAHA OPERATING COMPANY, LLC
Entity type:Organization
Organization Name:SNF OMAHA OPERATING COMPANY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-542-2253
Mailing Address - Street 1:1131 PAPILLION PARKWAY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4651
Mailing Address - Country:US
Mailing Address - Phone:402-670-8785
Mailing Address - Fax:
Practice Address - Street 1:1131 PAPILLION PKY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4651
Practice Address - Country:US
Practice Address - Phone:402-934-7500
Practice Address - Fax:402-934-7560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE285289Medicare Oscar/Certification