Provider Demographics
NPI:1821420266
Name:CHI NATIONAL HOME CARE, LLC
Entity Type:Organization
Organization Name:CHI NATIONAL HOME CARE, LLC
Other - Org Name:CHI HEALTH AT HOME - OMAHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. FINANCE & CFO
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-576-8478
Mailing Address - Street 1:6281 TRI RIDGE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8345
Mailing Address - Country:US
Mailing Address - Phone:513-576-0262
Mailing Address - Fax:
Practice Address - Street 1:2401 S 73RD ST STE 302
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2307
Practice Address - Country:US
Practice Address - Phone:402-898-8000
Practice Address - Fax:402-898-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026383000Medicaid
NE28-1500Medicare UPIN