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GAHC3 BENNINGTON NE ALF TRS SUB LLC NPI 1629458351


NPI Information

NPI: 1629458351
Provider Name: GAHC3 BENNINGTON NE ALF TRS SUB, LLC

Doing Business As: RIDGEWOOD ACTIVE RETIREMENT COMMUNITY

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 28D2101701

Address:
12301 N 149TH CIR
BENNINGTON, NE
ZIP 68007
Phone: (402) 884-7644
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GAHC3 BENNINGTON NE ALF TRS SUB, LLC is an assisted living facility in Bennington, NE. The provider is 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. GAHC3 BENNINGTON NE ALF TRS SUB, LLC NPI is 1629458351. The provider is registered as an organization entity type.
The provider Is Doing Business As Ridgewood Active Retirement Community.

The provider's business location address is:

12301 N 149TH CIR
BENNINGTON, NE
ZIP 68007-775
Phone: (402) 884-7644
Fax: (402) 884-8631

The provider's authorized official is Danny Prosky .
The authorized official title is Authorized Representative and has the following contact phone number (949) 270-9200.

The CLIA number assigned to this NPI record is 28D2101701 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2015 and was last updated on 6/8/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110025948400MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.