Healthcare Provider Details

I. General information

NPI: 1013800093
Provider Name (Legal Business Name): DOEN A HEART HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 BINNEY ST
OMAHA NE
68110-2007
US

IV. Provider business mailing address

1511 BINNEY ST
OMAHA NE
68110-2007
US

V. Phone/Fax

Practice location:
  • Phone: 402-850-9715
  • Fax:
Mailing address:
  • Phone: 402-850-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: RONDELL MOORE
Title or Position: OWNER
Credential:
Phone: 402-850-9715