IndividualActive
Kathleen Shaw
NPI 1407515398 · Intellectual Disabilities Intermediate Care Facility · Roseland, NE
Provider details
- NPI number
- 1407515398
- Entity type
- Individual
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Chore Provider372500000X
Nursing Service Related Providers
- Driver172A00000X
Other Service Providers
- Personal Care Attendant3747P1801X
Nursing Service Related Providers
Practice location
15665 W Cimarron Rd
Roseland, NE 68973-1814
Phone: (402) 469-5021
Approximate (ZIP-level) locationGet directions
Mailing address
15665 W Cimarron Rd
Roseland, NE 68973-1814
Registry dates
- Enumerated
- 2021-12-08
- Last updated
- 2025-02-03
- Certified
- 2025-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.