Provider Demographics
NPI:1619464971
Name:EHR.1RECORD LLC
Entity Type:Organization
Organization Name:EHR.1RECORD LLC
Other - Org Name:PICKET FENCE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:CHERIE
Authorized Official - Last Name:OUELLETTE-BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-990-5605
Mailing Address - Street 1:4611 S 96TH ST STE 154
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1242
Mailing Address - Country:US
Mailing Address - Phone:402-765-8241
Mailing Address - Fax:402-506-9134
Practice Address - Street 1:4611 S 96TH ST STE 154
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1242
Practice Address - Country:US
Practice Address - Phone:402-765-8241
Practice Address - Fax:402-506-9134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-21
Last Update Date:2018-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE251E00000X, 253Z00000X, 376J00000X
372600000X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty