GRAND ISLAND COUNTRYHOUSE LLC (NPI# 1265723829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265723829 |
| Entity Type | Organization |
| Organization Name | GRAND ISLAND COUNTRYHOUSE LLC |
| Practice Address |
833 N Alpha St Grand Island NE 68803-4321 |
| Practice Telephone | 3083811988 |
| Practice Fax Number | 3083814005 |
| Mailing Telephone | 3083811988 |
| Mailing Fax Number | 3083814005 |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2011-04-29 |
| Authorized Official Name | STACY GLOCK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3083811988 |
| Is Organization Subpart | Y |
| Parent Organization Name | AGEMARK CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | ALF300 | NE | Nursing & Custodial Care Facilities |
| Street Address |
833 N ALPHA ST |
| City | GRAND ISLAND |
| State | NE |
| Zip Code | 68803-4321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053884 | Christopher Patrin | Counselor | 1811 West 2nd Street, Suite 450, Grand Island, NE 68803 | 2020-11-03 |
| 1942848593 | Specialized Outpatient Services | Counselor | 1811 West 2nd Street Suite 450, Grand Island, NE 68803 | 2019-12-13 |
| 1558910604 | Grand Island Regional Medical Center | General Acute Care Hospital | 3533 Prairieview Street, Grand Island, NE 68803 | 2019-09-10 |
| 1992225817 | Destiny Mostek | Dietitian, Registered | 2201 N. Broadwell Ave, Grand Island, NE 68803 | 2017-06-21 |
| 1184150591 | Brandy Rae Bird | Registered Nurse | Mosaic Msu 2905 West 5th Street, Grand Island, NE 68803 | 2017-05-04 |
| 1831633171 | Karla Jean Sextro | Counselor | 2112 W. Faidley Ave, Grand Island, NE 68803 | 2016-12-06 |
| 1689062895 | Good Hands Clinic PC | Specialist | 524 South Webb Rd, Suite 1, Grand Island, NE 68803 | 2014-12-23 |
| 1346664554 | Lindsey M Modlin | Dental Hygienist | 4234 New York Ave, Grandi Island, NE 68803 | 2014-02-07 |
| 1568711711 | Danessa Marie Kenney | Counselor | 908 N. Howard Ave. Suite 107, Nebraska Children's Home Society, Grand Island, NE 68803 | 2012-09-04 |
| 1649528563 | Nicole Morris | Physical Therapist | 2116 Faidley Ave, Grand Island, NE 68803 | 2012-08-27 |
| Find all providers in zip 68803 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285923631 | Edgewood Grand Island Senior Living | Alzheimer Center (Dementia Center) | 214 N. Piper, Grand Island, NE 68803-4027 | 2011-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629565452 | Compassionate Memory Care 2, Inc | Alzheimer Center (Dementia Center) | 407 S 86th St, Omaha, NE 68114-4250 | 2018-04-17 |
| 1962919472 | O'neill Senior Living, LLC | Alzheimer Center (Dementia Center) | 1203 E Hynes Ave., Oneill, NE 68763 | 2018-01-05 |
| 1871998104 | Hastings Memory Care, LLC | Alzheimer Center (Dementia Center) | 19209 Taylor Cir, Elkhorn, NE 68022-5234 | 2014-10-29 |
| 1679978134 | Fremont Memory Care, LLC | Alzheimer Center (Dementia Center) | 749 E 32nd St, Fremont, NE 68025-2312 | 2014-10-27 |
| 1093116998 | Countryhouse Residences | Alzheimer Center (Dementia Center) | 5030 S 155th St, Omaha, NE 68137-5002 | 2014-09-10 |
| 1235579525 | High Plains Alzheimer's Special Care Center | Alzheimer Center (Dementia Center) | 5601 S 84th St, Lincoln, NE 68516-4405 | 2013-07-01 |
| 1730425059 | The Waterford Memory Care South 27th, Inc. | Alzheimer Center (Dementia Center) | 8939 Keystone Dr, Lincoln, NE 68516-4127 | 2012-12-13 |
| 1780928036 | The Independence House Northview | Alzheimer Center (Dementia Center) | 1609 N St, Lincoln, NE 68508-1884 | 2012-11-26 |
| 1245512979 | Via Christe LLC | Alzheimer Center (Dementia Center) | 15677 Spaulding St, Omaha, NE 68116-8411 | 2011-09-20 |
| 1548559990 | Edgewood Columbus Senior Living | Alzheimer Center (Dementia Center) | 3386 53rd Ave., Columbus, NE 68601-1512 | 2011-04-06 |
| Find all providers with the same taxonomy | ||||
| City | GRAND ISLAND |
| Zip Code | 68803 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.