The Independence House Superior-Autumn House

NPI #1902100407 in Lincoln, Nebraska

Provider Information

NPI Number: 1902100407
Entity Type: Organization
Organization Name: The Independence House Superior-Autumn House
Subpart: Yes (part of a larger organization)
Parent Organization: EMERALD CARE COMPANY
Primary Specialty: Alzheimer Center (Dementia Center)
Enumeration Date: Dec 27, 2010
Last Updated: Nov 26, 2012

Practice Location

Address: 1740 SUPERIOR ST
City: Lincoln
State: Nebraska
ZIP Code: 68521-1502
Phone: (402) 438-7844

Authorized Official

Name: MS. MARSHA E. STORK
Title: PRESIDENT
Phone: (402) 475-7755

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Alzheimer Center (Dementia Center)	311500000X	Primary

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