Provider Demographics
NPI:1104815778
Name:CRETE AREA MECICAL CENTER LTC
Entity type:Organization
Organization Name:CRETE AREA MECICAL CENTER LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON/ASST. ADM
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-826-6805
Mailing Address - Street 1:1540 GROVE AVE
Mailing Address - Street 2:PO BOX 220
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-1749
Mailing Address - Country:US
Mailing Address - Phone:402-826-6867
Mailing Address - Fax:402-826-6827
Practice Address - Street 1:1540 GROVE AVE
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-1749
Practice Address - Country:US
Practice Address - Phone:402-826-6867
Practice Address - Fax:402-826-6827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NELTCH009311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home