Provider Demographics
NPI:1720630635
Name:ARBOR CARE CENTERS - FULLERTON LLC
Entity type:Organization
Organization Name:ARBOR CARE CENTERS - FULLERTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:KLAASMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-525-1251
Mailing Address - Street 1:202 N ESTHER ST
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:NE
Mailing Address - Zip Code:68638-3029
Mailing Address - Country:US
Mailing Address - Phone:308-536-2488
Mailing Address - Fax:308-536-4134
Practice Address - Street 1:202 N ESTHER ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:NE
Practice Address - Zip Code:68638-3029
Practice Address - Country:US
Practice Address - Phone:308-536-2488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility