Provider Demographics
NPI:1184421844
Name:SWEET MILES LLC
Entity type:Organization
Organization Name:SWEET MILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-466-1900
Mailing Address - Street 1:3310 N 191ST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-3351
Mailing Address - Country:US
Mailing Address - Phone:531-466-1900
Mailing Address - Fax:
Practice Address - Street 1:3310 N 191ST AVE
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3351
Practice Address - Country:US
Practice Address - Phone:531-466-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child