Healthcare Provider Details

I. General information

NPI: 1245164474
Provider Name (Legal Business Name): TIMEAKI LASHANTE ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7714 N 113TH AVENUE CIR
OMAHA NE
68142-1140
US

IV. Provider business mailing address

7714 N 113TH AVENUE CIR
OMAHA NE
68142-1140
US

V. Phone/Fax

Practice location:
  • Phone: 531-222-7435
  • Fax:
Mailing address:
  • Phone: 531-222-7435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: