SOUTHLAKE VILLAGE REHABILITATION AND CARE CENTER
NPI 1407964240
Skilled Nursing Facility in Lincoln, NE

Active since August 29, 2006CLIA 28D0455351 · Waiver
9401 ANDERMATT DR, LINCOLN, NE 68526(402) 476-3274(402) 746-6395 Get Directions Write a Review

NPPES record last updated: August 3, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southlake Village Rehabilitation And Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHLAKE VILLAGE REHABILITATION AND CARE CENTER (NPI 1407964240) is a healthcare organization registered as a skilled nursing facility in Lincoln, Nebraska and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jack Dean Vetter, President, as its authorized official.

NPPES Registry Identity

NPI1407964240
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMANOR OF LINCOLN, INC
Location Address9401 ANDERMATT DRLincoln, NE 68526-9507
Mailing Address9401 Andermatt DrLincoln, NE 68526-9507 · (402) 476-3274 · Fax (402) 746-6395
Fax(402) 746-6395
Organization SubpartNo
Authorized OfficialJack Dean VetterPresident · (402) 895-3932
Enumeration DateAugust 29, 2006
Last NPPES UpdateAugust 3, 2011
NPI 1407964240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in NE · 504010
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
9401 ANDERMATT DR, Lincoln, NE 68526

Other Names 1

Doing Business AsSouthlake Village Rehabilitation And Care Center

Other Identifiers 3

Medicare NSC0470310001NE
Medicare ID-Type Unspecified28D0455351NE · Medicare Clia Waiver
Medicare OSCAR/certification285219NE

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 28D0455351

Manor Of Lincoln, Inc · Lincoln, NE
Active · expires Aug 31, 2026
CLIA Number28D0455351
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMs. Michelle Santistevan
Laboratory Phone(402) 476-3274
Laboratory LocationManor Of Lincoln, Inc9401 Andermatt Drive, Lincoln, NE 68526
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
9401 ANDERMATT DR
LINCOLN, NE 68526
Occupational Therapist
9401 ANDERMATT DR
LINCOLN, NE 68526
Physical Therapy Assistant
9401 ANDERMATT DR
LINCOLN, NE 68526
Physical Therapy Assistant
9401 ANDERMATT DR
LINCOLN, NE 68526
Skilled Nursing Facility
9401 ANDERMATT DR
LINCOLN, NE 68526
Speech-Language Pathologist
9401 ANDERMATT DR
LINCOLN, NE 68526
Physical Therapy Assistant
9401 ANDERMATT DR
LINCOLN, NE 68526
Occupational Therapist
9401 ANDERMATT DR
LINCOLN, NE 68526

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Manor Of Lincoln, Inc's NPI number?

The NPI number for Manor Of Lincoln, Inc is 1407964240. It was assigned to this organization in the NPPES registry on August 29, 2006. The provider is doing business as Southlake Village Rehabilitation And Care Center.

Where is Manor Of Lincoln, Inc located?

Manor Of Lincoln, Inc is located at 9401 Andermatt Dr, Lincoln, NE 68526. The listed phone number is (402) 476-3274.

What is Manor Of Lincoln, Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Manor Of Lincoln, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D0455351) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Manor Of Lincoln, Inc was last updated on August 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.