Healthcare Provider Details

I. General information

NPI: 1982419701
Provider Name (Legal Business Name): ANEW SHARED LIVING PROVDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9561 S 32ND ST
LINCOLN NE
68516-1672
US

IV. Provider business mailing address

9561 S 32ND ST
LINCOLN NE
68516-1672
US

V. Phone/Fax

Practice location:
  • Phone: 402-570-4633
  • Fax: 402-387-7559
Mailing address:
  • Phone: 402-570-4633
  • Fax: 402-387-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. CLAIRE ANNE WILKINS
Title or Position: EXECUTIVE DIRECTOR/OWNER
Credential:
Phone: 402-570-4633