Provider Demographics
NPI:1770381980
Name:MY LIFE LLC
Entity type:Organization
Organization Name:MY LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LARABEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-393-0753
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-0787
Mailing Address - Country:US
Mailing Address - Phone:402-393-0753
Mailing Address - Fax:402-403-5289
Practice Address - Street 1:11716 W DODGE RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2425
Practice Address - Country:US
Practice Address - Phone:402-393-0753
Practice Address - Fax:402-403-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No385H00000XRespite Care FacilityRespite Care