Provider Demographics
NPI:1528340528
Name:IMMANUEL RETIREMENT COMMUNITIES
Entity type:Organization
Organization Name:IMMANUEL RETIREMENT COMMUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-829-2943
Mailing Address - Street 1:1044 N 115TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4425
Mailing Address - Country:US
Mailing Address - Phone:402-829-2943
Mailing Address - Fax:402-829-2998
Practice Address - Street 1:522 W LINCOLN ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3121
Practice Address - Country:US
Practice Address - Phone:402-614-5500
Practice Address - Fax:402-614-5503
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMMANUEL RETIREMENT COMMUNITIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-15
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF088310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility