Cclive, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

CCLIVE, LLC

Practice address

1307 16TH St
Central City, NE 68826-1809

Phone

(308) 946-2276

Fax

(308) 946-9887

NPI assigned

Apr 24, 2019

Last updated

Apr 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Donna Marie Sautter

Title

Administrator

Phone

(308) 946-2276

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556064000000",
    "number": "1184288284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 16TH ST",
            "city": "CENTRAL CITY",
            "state": "NE",
            "postal_code": "688261809",
            "telephone_number": "308-946-2276",
            "fax_number": "308-946-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 16TH ST",
            "city": "CENTRAL CITY",
            "state": "NE",
            "postal_code": "688261809",
            "telephone_number": "308-946-2276",
            "fax_number": "308-946-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCLIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "SAUTTER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-946-2276",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04630562",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cclive12@msn.com",
            "affiliation": "N",
            "endpointDescription": "by/Donna Sautter",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1307 16th St",
            "city": "Central City",
            "state": "NE",
            "country_code": "US",
            "postal_code": "688261809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laurel Blodgett, RN, BSN
• Wendy M Botsch, RDH
• Shawna L Brown
• Nicole Marie Brunckhorst
• Brian Keith Buhlke, D.O.
• Central Assisted Living, Inc.
• Central City Chiropractic & Wellness Clinic PC
• Central City Opco LLC (Adept Nursing & Rehab of Central City)
• Central Transport LLC
• City of Central City (Central City Ambulance Service)

• Adult Day Care Clinic/Center in Central City, NE
• Providers in Central City, NE by specialty
• Adult Day Care Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.