Provider Demographics
NPI:1629660774
Name:OMAHA NE HOME CAREGIVING LLC
Entity Type:Organization
Organization Name:OMAHA NE HOME CAREGIVING LLC
Other - Org Name:CORNERSTONE CAREGIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-991-7836
Mailing Address - Street 1:209 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7415
Mailing Address - Country:US
Mailing Address - Phone:817-991-7836
Mailing Address - Fax:
Practice Address - Street 1:1810 N 203RD ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-2885
Practice Address - Country:US
Practice Address - Phone:402-251-5770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE CAREGIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-10
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care