NPIMap

Organization Active NPI

Custer Care

  • Assisted Living Facility
  • Broken Bow, NE
National Provider Identifier
1275827412
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
ALF322 Issued in NE
Legal business name
CUSTER CARE
Practice address
1020 50 2ND Ave
Broken Bow., NE 68822-1422
Phone
(308) 872-6303
Fax
(308) 872-2677
NPI assigned
Jun 6, 2011
Last updated
Dec 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Tiffany Alice Glidden
Title
Administrator
Phone
(308) 872-6303

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Nursing Care Agency 251J00000X NU
Adult Day Care Clinic/Center 261QA0600X NU
Assisted Living Facility 310400000X ALF322 NE Primary
In Home Supportive Care Agency 253Z00000X NU
Supports Brokerage Agency 251X00000X NU

Addresses

Primary practice location

1020 50 2ND Ave
Broken Bow., NE 68822-1422

Mailing address

1020 50 2ND Ave
Broken Bow., NE 68822-1422
Phone (308) 872-6303

Other identifiers 1

IdentifierTypeStateIssuer
10025661500MedicaidNE

National Provider Directory

National Provider Directory
Tax ID family
Custer Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

346 N 16th Ave
Broken Bow, NE 68822

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1275827412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 50 2ND AVE",
            "city": "BROKEN BOW.",
            "state": "NE",
            "postal_code": "688221422",
            "telephone_number": "308-872-6303",
            "fax_number": "308-872-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 50 2ND AVE",
            "city": "BROKEN BOW.",
            "state": "NE",
            "postal_code": "688221422",
            "telephone_number": "308-872-6303",
            "fax_number": "308-872-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTER CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "GLIDDEN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "308-872-6303"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF322",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025661500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Bow, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.