Healthcare Provider Details

I. General information

NPI: 1740099563
Provider Name (Legal Business Name): CIRCLE OF FRIENDS IN HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 CUSTER AVE
NORFOLK NE
68701-0859
US

IV. Provider business mailing address

802 CUSTER AVE
NORFOLK NE
68701-0859
US

V. Phone/Fax

Practice location:
  • Phone: 402-371-3567
  • Fax:
Mailing address:
  • Phone: 402-371-3567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VICKI MAHIN
Title or Position: OWNER
Credential: OWNER
Phone: 402-649-4442