28D2101701 CLIA NUMBER - RIDGEWOOD SENIOR LIVING

Laboratory Demographics

CLIA Number: 28D2101701

Facility Name: RIDGEWOOD SENIOR LIVING

Facility Address:
12301 NORTH 149TH CIRCLE
BENNINGTON, NE
ZIP 68007
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Facility Phone Number: 402 884-7644

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1629458351

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	28D2101701
LAB Type	Assisted Living Facility
Facility Name	RIDGEWOOD SENIOR LIVING
Street	12301 NORTH 149TH CIRCLE
City	BENNINGTON
State	NE
ZIP	68007
Phone	402 884-7644
CertificateType	4
CertificateEffectiveDate	11/3/2022
CertificateExpirationDate	11/2/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024