Blue Valley Lutheran Homes Society Inc

Key facts

NPI: 1972591808
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
License: 764002 (NE)
Legal business name: BLUE VALLEY LUTHERAN HOMES SOCIETY INC
Practice address: 220 Park Avenue
Hebron, NE 68370-2008
Phone: (402) 768-3900
Fax: (402) 768-3901
NPI assigned: Oct 13, 2005
Organization subpart: No

Authorized official

Name: Mr. Doug A Chos
Title: Chief Executive Officer
Phone: (402) 768-3900

Corporate family (same tax ID) 2

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

Blue Valley Lutheran Homes Society Inc Nursing Facility/Intermediate Care Facility · Hebron, NE · NPI 1770571606

NPD tax ID
Blue Valley Lutheran Homes Society Inc Assisted Living Facility · Hebron, NE · NPI 1932391729

NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Bryan A Hubl, M.D. Family Medicine Physician · Hebron, NE · NPI 1700867892

NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Bryan A Hubl, M.D. Family Medicine Physician · Hebron, NE · NPI 1700867892

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Blue Valley Lutheran Nursing Home CCN 285259
Overall star rating: ★★★☆☆ 3 of 5
Health inspections: ★★★★★ 5 of 5
Staffing: ★☆☆☆☆ 1 of 5
Quality measures: ★☆☆☆☆ 1 of 5
Type: Medicare and Medicaid
Ownership: Non profit - Church related
Certified: Jul 1, 2004
Medicare certification status: Active (Provider of Services file)
Certified beds: 64 · 28.3 residents per day on average

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
28D0861916	Blue Valley Lutheran Homes Society Inc Dba 220 Park Ave, Hebron, NE 68370	Certificate of waiver	Aug 31, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NE

Skilled nursing facility certification: CCN 285259

Legal name: BLUE VALLEY LUTHERAN HOMES SOCIETY, INC
Doing business as: BLUE VALLEY LUTHERAN NURSING HOMES
Certification status: Active
Provider type (POS): Nursing home – SNF/NF dual certification
Participating since: Jul 1, 2004
Last certification: Jun 27, 2024
Beds: 64
Ownership / control type: Church Related
Organization structure: Corporation · Non-profit
Incorporated: Dec 1, 1948 in NE
Enrollment address: 220 Park Ave
Box 166
Hebron, NE 68370-2008
Nursing home name: BLUE VALLEY LUTHERAN NURSING HOME

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Name	Role	Since	Share
Lori a Wittler Individual	W-2 Managing Employee Cfo	Dec 8, 2008	50%
Doug a Chos Individual	Corporate Officer Ceo	Sep 1, 2021	100%
	W-2 Managing Employee Ceo/Administrator	Sep 1, 2021	50%
	Operational/Managerial Control Ceo / Administrator	Sep 1, 2021	100%

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040408000062	NE	Part a Provider - Skilled Nursing Facility	8022001528	Practice locations: Hebron, NE

National Provider Directory

Tax ID family: Blue Valley Lutheran Homes Society Inc (3 organizations share this tax ID)

Locations

220 Park Ave
#166
Hebron, NE 68370
Phone (402) 768-6045

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X	764002	NE	Yes

Addresses

Primary practice location

220 Park Avenue
Hebron, NE 68370-2008

Mailing address

P.O. Box 166
P. O. Box 166
Hebron, NE 68370-2008
Phone (402) 768-3900

Other names

Blue Valley Lutheran Nursing Home Doing business as

Other providers in Hebron, NE

Crystal Kellie Bauer
Rashmika Bhakta
Shirish B Bhakta
Blue Valley Lutheran Homes Society Inc
Blue Valley Lutheran Homes Society Inc
Sarah Bolte
Chie Boyer, MA, CCC-SLP
Emily Chamberlain
City of Hebron
Bradley Donald Cooper, PT, DPT, OCS, CSCS

All providers in Hebron, NE · Skilled Nursing Facility in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (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.