Organization Active NPI

Compassionate Memory Care 1 Inc

  • Alzheimer Center (Dementia Center)
  • Omaha, NE
National Provider Identifier
1154620078
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
ALF317 Issued in NE
Legal business name
COMPASSIONATE MEMORY CARE 1 INC
Practice address
2402 N 102ND St
Omaha, NE 68134-5530
Phone
(402) 391-1499
Fax
(402) 391-9774
NPI assigned
Mar 17, 2011
Last updated
Mar 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lisa Kay Graper
Title
President
Phone
(402) 699-3761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X ALF317 NE Primary

Addresses

Primary practice location

2402 N 102ND St
Omaha, NE 68134-5530

Mailing address

14805 Dayton St
Omaha, NE 68137-5373
Phone (402) 612-6789

Other identifiers 1

IdentifierTypeStateIssuer
100255436-00MedicaidNE

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1154620078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14805 DAYTON ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681375373",
            "telephone_number": "402-612-6789",
            "fax_number": "402-894-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 N 102ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681345530",
            "telephone_number": "402-391-1499",
            "fax_number": "402-391-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE MEMORY CARE 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "GRAPER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-699-3761",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NE",
            "license": "ALF317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100255436-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.