- Enrollment id
- O20190410002026
- Enrollment state
- NE
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1154882504
- Multiple npi flag
- N
- Ccn
- 285104
- Associate id
- 7810238318
- Organization name
- PLATTSMOUTH OPERATIONS LLC
- Doing business as name
- PRESTIGE CARE CENTER OF PLATTSMOUTH
- Incorporation date
- 2019-03-20
- Incorporation state
- NE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PRESTIGE CARE CENTER OF PLATTSMOUTH
- Affiliation entity name
- PRESTIGE CARE CENTER
- Affiliation entity id
- 602
- Address line 1
- 602 S 18TH ST
- City
- PLATTSMOUTH
- State
- NE
- Zip code
- 680482056