Healthcare Provider Details

I. General information

NPI: 1710990577
Provider Name (Legal Business Name): HENDERSON HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 FRONT ST
HENDERSON NE
68371-8902
US

IV. Provider business mailing address

1621 FRONT ST
HENDERSON NE
68371-8902
US

V. Phone/Fax

Practice location:
  • Phone: 402-723-4512
  • Fax: 402-723-4520
Mailing address:
  • Phone: 402-723-4512
  • Fax: 402-723-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JILL ANN MYERS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 402-723-4512