Provider Demographics
NPI:1033616081
Name:HOMAHA SENIOR CARE LLC
Entity Type:Organization
Organization Name:HOMAHA SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:WESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-249-6136
Mailing Address - Street 1:4908 CASS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2913
Mailing Address - Country:US
Mailing Address - Phone:402-249-6136
Mailing Address - Fax:402-835-5212
Practice Address - Street 1:4908 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-2913
Practice Address - Country:US
Practice Address - Phone:402-249-6136
Practice Address - Fax:402-835-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty