Provider Demographics
NPI:1992771299
Name:THE AMBASSADOR NEBRASKA CITY, INC.
Entity type:Organization
Organization Name:THE AMBASSADOR NEBRASKA CITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-873-8507
Mailing Address - Street 1:1800 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-1159
Mailing Address - Country:US
Mailing Address - Phone:402-873-8507
Mailing Address - Fax:402-873-7244
Practice Address - Street 1:1800 14TH AVE
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-1159
Practice Address - Country:US
Practice Address - Phone:402-873-6650
Practice Address - Fax:402-873-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE584001225100000X, 225X00000X, 235Z00000X, 314000000X
NEALF168310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0516670001OtherDME SUPPLIER
NE100260964-00Medicaid
NE=========-32Medicaid
NE=========-69Medicaid
NE100260964-00Medicaid
NE=========-00Medicaid
NE=========-01Medicaid