Healthcare Provider Details

I. General information

NPI: 1548954308
Provider Name (Legal Business Name): NEWLAND HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 DODGE ST STE 108
OMAHA NE
68131-3218
US

IV. Provider business mailing address

3610 DODGE ST STE 108
OMAHA NE
68131-3218
US

V. Phone/Fax

Practice location:
  • Phone: 308-293-5085
  • Fax:
Mailing address:
  • Phone: 308-293-5085
  • 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 Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BOOL W KUICH
Title or Position: PRESIDENT
Credential:
Phone: 308-293-5085