Healthcare Provider Details

I. General information

NPI: 1346827821
Provider Name (Legal Business Name): P-31 SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 S 50TH ST STE 302
OMAHA NE
68117-1355
US

IV. Provider business mailing address

7935 N 154TH AVE
BENNINGTON NE
68007-1819
US

V. Phone/Fax

Practice location:
  • Phone: 402-718-6700
  • Fax:
Mailing address:
  • Phone: 402-718-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: SHANICE B JACKSON
Title or Position: PRESIDENT
Credential:
Phone: 402-718-6700