CSL Miracle Hills, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALF156 Issued in NE

Legal business name

CSL MIRACLE HILLS, LLC

Practice address

11909 Miracle Hills Dr
Omaha, NE 68154

Phone

(402) 431-0011

Fax

(402) 431-9257

NPI assigned

Jul 6, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Gloria Holland

Title

VP-Finance

Phone

(972) 770-5600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Waterford at Miracle Hills Doing business as

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278374400000",
    "number": "1487966537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 DALLAS PARKWAY",
            "address_2": "SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75254",
            "telephone_number": "972-770-5600",
            "fax_number": "972-770-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11909 MIRACLE HILLS DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-431-0011",
            "fax_number": "402-431-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSL MIRACLE HILLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VP-FINANCE",
        "authorized_official_telephone_number": "972-770-5600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100258495-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Waterford at Miracle Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Omaha, NE
• Providers in Omaha, NE by specialty
• Assisted Living Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.