Healthcare Provider Details

I. General information

NPI: 1376465179
Provider Name (Legal Business Name): FOREVER FAMILY IN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W 4TH ST STE 114B
NORTH PLATTE NE
69101-1104
US

IV. Provider business mailing address

1620 W 4TH ST STE 114B
NORTH PLATTE NE
69101-1104
US

V. Phone/Fax

Practice location:
  • Phone: 308-231-0775
  • Fax:
Mailing address:
  • Phone: 308-231-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIC J WILLIS
Title or Position: OWNER
Credential:
Phone: 308-231-0775