GRANVILLE ASSISTED LIVING, LLC (NPI# 1730385709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730385709 |
| Entity Type | Organization |
| Organization Name | GRANVILLE ASSISTED LIVING, LLC |
| Practice Address |
5807 Granville Parkway La Vista NE 68128 |
| Mailing Address |
78 Centennial Loop Eugene OR 97401-7900 |
| Practice Telephone | 4029336405 |
| Practice Fax Number | 4025059144 |
| Mailing Telephone | 5417473373 |
| Mailing Fax Number | 5417470673 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | MR. JOHN HOLTZ (CONTROLLER) |
| Authorized Official Telephone | 5417473373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Street Address |
5807 GRANVILLE PARKWAY |
| City | LA VISTA |
| State | NE |
| Zip Code | 68128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922589746 | Ruth Ann Moses | Prevention Professional | 7030 S 110th St, Omaha, NE 68128 | 2018-08-29 |
| 1972945897 | Jenna Leigh Graeve | Physical Therapist | 7040 S 114th St Plz Apt 203, La Vista, NE 68128 | 2013-07-19 |
| 1245564012 | Optum Infusion Services 302, LLC | Pharmacy | 8720 South 114th Street, Suite 106, La Vista, NE 68128 | 2009-09-28 |
| 1629160072 | Rachel L. Mccann | Pediatrics | 9801 Giles Road, Suite 1, La Vista, NE 68128 | 2006-09-29 |
| 1730118233 | Donald R Krysl | Optometrist | 8102 S 84th St, Lavista, NE 68128 | 2006-06-30 |
| 1073030607 | September Leigh Wanzenried | Family Medicine | 6901 S 84th St, La Vista, NE 68128 | 2017-08-24 |
| 1518312719 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1245685445 | Costco Wholesale Corporation | Hearing Aid Equipment | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1386011971 | Kelsey Klatt | Occupational Therapist | 6960 S 110th St, La Vista, NE 68128 | 2015-08-31 |
| 1003299827 | Jordan Tichenor | Internal Medicine | 8604 Giles Rd, La Vista, NE 68128 | 2015-06-30 |
| Find all providers in zip 68128 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811331762 | Safeway Pharmacy | Point of Service | 4246 450th Rd, Hay Springs, NE 69347-4236 | 2013-04-23 |
| 1194096065 | Jones Family Dental PC | Point of Service | 6530 Sorensen Pkwy, Omaha, NE 68152-2138 | 2012-01-24 |
| 1740592534 | Triba Chiropractic Clinic, P.C. | Point of Service | 2720 S 114th St, Omaha, NE 68144-4712 | 2010-07-08 |
| 1396012076 | Gary A Elsasser D C P C | Point of Service | 11906 I St, Omaha, NE 68137-1244 | 2011-11-22 |
| 1528344280 | Walgreens Pharmacy | Point of Service | 533 S Lincoln Ave, York, NE 68467-4211 | 2011-10-26 |
| 1922336353 | John D. Peters, M.d., P.C. | Point of Service | 7802 Davenport St, Omaha, NE 68114-3629 | 2009-11-23 |
| 1780861948 | Healing Hands Wellness Center Inc | Point of Service | 106 S Maple St, Plainview, NE 68769-4124 | 2008-01-29 |
| 1700955929 | Optical Options | Point of Service | 715 N Kansas Ave, Suite 300, Hastings, NE 68901 | 2006-11-06 |
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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.