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Contact Information

LOGAN VALLEY MANOR LLC
1035 DIAMOND ST
LYONS, NE68038-2501
 Phone: 402-687-2636
 Fax: 402-687-2638
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for LOGAN VALLEY MANOR LLC

NPI Number 1396059051
LBN Legal business name LOGAN VALLEY MANOR LLC
Authorized official GARETT ROBERTSON - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/04/2010
Last updated 01/20/2012 - About 14 years ago
Identifiers
NE License # 084001
NE Medicaid 10026103200
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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