Healthcare Provider Details

I. General information

NPI: 1043017767
Provider Name (Legal Business Name): COMPASSION & CARE NEBRASKA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9502 FORT ST
OMAHA NE
68134-1703
US

IV. Provider business mailing address

9502 FORT ST
OMAHA NE
68134-1703
US

V. Phone/Fax

Practice location:
  • Phone: 402-502-2647
  • Fax: 531-867-4638
Mailing address:
  • Phone: 402-502-2647
  • Fax: 531-867-4638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MORGAN LEWIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 402-502-2647