Provider Demographics
NPI:1801898176
Name:FIRSTCARE HOME HEALTH OF EASTERN NEBRASKA, INC
Entity type:Organization
Organization Name:FIRSTCARE HOME HEALTH OF EASTERN NEBRASKA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BRENNFOERDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:402-435-1122
Mailing Address - Street 1:3901 NORMAL BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5200
Mailing Address - Country:US
Mailing Address - Phone:402-435-1122
Mailing Address - Fax:402-435-4854
Practice Address - Street 1:3901 NORMAL BLVD
Practice Address - Street 2:STE 102
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5200
Practice Address - Country:US
Practice Address - Phone:402-435-1122
Practice Address - Fax:402-435-4854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE501003251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========14Medicaid
NE=========14Medicaid