Healthcare Provider Details

I. General information

NPI: 1326140138
Provider Name (Legal Business Name): CHILDRENS HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 S 84TH ST
OMAHA NE
68124-3215
US

IV. Provider business mailing address

8200 DODGE ST
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-7777
  • Fax: 402-955-5062
Mailing address:
  • Phone: 402-955-6826
  • Fax: 402-955-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number261006
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2068
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License NumberRCS3
License Number StateNE

VIII. Authorized Official

Name: CHANDA CHACON
Title or Position: PRESIDENT & CEO
Credential:
Phone: 402-955-6826