Healthcare Provider Details

I. General information

NPI: 1164133666
Provider Name (Legal Business Name): HOLISTIC HOME HEALTH & COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 N 24TH ST STE 108
OMAHA NE
68110-2312
US

IV. Provider business mailing address

2118 N 24TH ST STE 108
OMAHA NE
68110-2312
US

V. Phone/Fax

Practice location:
  • Phone: 402-707-1053
  • Fax:
Mailing address:
  • Phone: 402-707-1053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BRIONA L WILSON
Title or Position: OWNER
Credential:
Phone: 402-707-1053