Healthcare Provider Details

I. General information

NPI: 1134628803
Provider Name (Legal Business Name): SPECIALIZED HANDS LUVLYEYIZ CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 PARK AVE APT 804
OMAHA NE
68105
US

IV. Provider business mailing address

6311 AMES AVE # 1109
OMAHA NE
68104-2027
US

V. Phone/Fax

Practice location:
  • Phone: 402-543-1567
  • Fax:
Mailing address:
  • Phone: 402-543-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. SHANEKA VICTORIA YOUNG
Title or Position: INDEPENDENT PROVIDER
Credential:
Phone: 402-543-1567