Healthcare Provider Details

I. General information

NPI: 1831908391
Provider Name (Legal Business Name): JEFF L NEELEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 S 36TH ST
OMAHA NE
68105-3136
US

IV. Provider business mailing address

3302 WALNUT ST
OMAHA NE
68105-2540
US

V. Phone/Fax

Practice location:
  • Phone: 402-637-2215
  • Fax:
Mailing address:
  • Phone: 402-637-2215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number0645
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number39255718
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: