Provider Demographics
NPI:1235770488
Name:ADORN SENIOR HOME CARE LLC
Entity Type:Organization
Organization Name:ADORN SENIOR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-637-2373
Mailing Address - Street 1:14916 REDMAN AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-1448
Mailing Address - Country:US
Mailing Address - Phone:402-637-2373
Mailing Address - Fax:
Practice Address - Street 1:14916 REDMAN AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-1448
Practice Address - Country:US
Practice Address - Phone:402-637-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health