Healthcare Provider Details
I. General information
NPI: 1356966766
Provider Name (Legal Business Name): APOSTLE NURSING HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2020
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1941 S 42ND ST STE 129
OMAHA NE
68105-2938
US
IV. Provider business mailing address
1941 S 42ND ST STE 129
OMAHA NE
68105-2938
US
V. Phone/Fax
- Phone: 402-515-1768
- Fax: 402-763-2545
- Phone: 402-515-1768
- Fax: 402-763-2545
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
KRISTI
L
KELLOGG
Title or Position: COO/CO-OWNER
Credential: RN
Phone: 402-515-1768