Provider Demographics
NPI:1982097762
Name:EBJ DETERDING, LLC
Entity Type:Organization
Organization Name:EBJ DETERDING, LLC
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DETERDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-488-4421
Mailing Address - Street 1:2120 S 56TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-488-4421
Mailing Address - Fax:888-456-0118
Practice Address - Street 1:2120 S 56TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2118
Practice Address - Country:US
Practice Address - Phone:402-488-4421
Practice Address - Fax:888-456-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health