Healthcare Provider Details

I. General information

NPI: 1558243766
Provider Name (Legal Business Name): EH HSER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 G ST APT 2
LINCOLN NE
68508-3772
US

IV. Provider business mailing address

4911 N 64TH ST
OMAHA NE
68104-1908
US

V. Phone/Fax

Practice location:
  • Phone: 531-232-1729
  • Fax:
Mailing address:
  • Phone: 402-609-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: