Healthcare Provider Details

I. General information

NPI: 1346123593
Provider Name (Legal Business Name): FAMILIES AND CONNECTIONS COLLABORATIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5678 N 103RD ST
OMAHA NE
68134-1007
US

IV. Provider business mailing address

5678 N 103RD ST
OMAHA NE
68134-1007
US

V. Phone/Fax

Practice location:
  • Phone: 531-210-6032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANELLE HARDIMAN
Title or Position: CEO
Credential:
Phone: 531-210-6032