Healthcare Provider Details

I. General information

NPI: 1285091074
Provider Name (Legal Business Name): DIGNITY HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2016
Last Update Date: 01/18/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 N 90TH ST
OMAHA NE
68134-4136
US

IV. Provider business mailing address

4201 N 90TH ST
OMAHA NE
68134-4136
US

V. Phone/Fax

Practice location:
  • Phone: 402-401-6689
  • Fax: 402-939-0557
Mailing address:
  • Phone: 402-401-6689
  • Fax: 402-939-0557

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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: M'MOUPIENTILA NDA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 402-401-6689