CCN: 285087 NPI: 1326578956 Organization

Tiffany Square

3119 W FAIDLEY AVE
GRAND ISLAND, NE 688034114

Contact Information

Phone 3083842333
Fax 3083843620
Enumeration Date 2017-06-15
Last Updated 2025-07-24

Taxonomies

Code: 314000000X (Primary) License State: NE License: 374006

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 0.9914020876

censusDivision 4

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 0.9849245109

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 0.9811539489

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 0.992

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 0.992

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 0.9865908768

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 1.0093041415

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 1.009379651

censusDivision 6

cbsaActualGeographicLocation 24260

providerType 38

caseMixIndex 1.0

operatingCostToChargeRatio 1.0

vbpAdjustment 1.009379651

Outpatient Payment Attributes (OPSF) View Dictionary →

No OPSF records found for this provider.