Healthcare Provider Details

I. General information

NPI: 1285438432
Provider Name (Legal Business Name): WELLNESS PORTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 GALVIN RD S UNIT 105106
BELLEVUE NE
68005-2202
US

IV. Provider business mailing address

16524 CEDAR ST
OMAHA NE
68130-1629
US

V. Phone/Fax

Practice location:
  • Phone: 513-253-5428
  • Fax:
Mailing address:
  • Phone: 513-253-5428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GEORGINA G ROESER
Title or Position: ADM. ASSISTANT
Credential:
Phone: 513-253-5428