Edgewood Hastings Senior Living

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

28D1059768 Issued in NE

Legal business name

EDGEWOOD HASTINGS SENIOR LIVING

Practice address

2400 W. 12TH St.
Hastings, NE 68901-3501

Phone

(402) 462-4633

Fax

(402) 462-6828

NPI assigned

Apr 6, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Rex Carlson, CPA

Title

Chief Financial Officer

Phone

(701) 738-2000

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1194014548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W. 12TH ST.",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689013501",
            "telephone_number": "402-462-4633",
            "fax_number": "402-462-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W. 12TH ST.",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689013501",
            "telephone_number": "402-462-4633",
            "fax_number": "402-462-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD HASTINGS SENIOR LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-06",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "REX",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "701-738-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NE",
            "license": "28D1059768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025787300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eagle Feather Counseling
• Cristianne Eaglefeather Moreno, LMHP, PLADC
• Eastern Ambulance Service Inc
• Tara Eastman
• Jamie Dawn Eberly, LMHP
• Lexie Marie Edstrom, OT
• Educational Service Unit 9
• Lorraine L Edwards, M.D.
• Braydon Ehlers
• Tori Ehlers, MS

• Alzheimer Center (Dementia Center) in Hastings, NE
• Providers in Hastings, NE by specialty
• Alzheimer Center (Dementia Center) in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.