Healthcare Provider Details

I. General information

NPI: 1831790823
Provider Name (Legal Business Name): SIMAIRA ANDERSON WOODS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2478 N 150TH ST
OMAHA NE
68116-5102
US

IV. Provider business mailing address

2478 N 150TH ST
OMAHA NE
68116-5102
US

V. Phone/Fax

Practice location:
  • Phone: 402-972-1671
  • Fax:
Mailing address:
  • Phone: 402-972-1671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: