Healthcare Provider Details

I. General information

NPI: 1588478614
Provider Name (Legal Business Name): SHELLY R HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 E HIGHWAY 20
ONEILL NE
68763-2104
US

IV. Provider business mailing address

915 E EVERETT ST
ONEILL NE
68763-2031
US

V. Phone/Fax

Practice location:
  • Phone: 402-336-4405
  • Fax:
Mailing address:
  • Phone: 402-889-0561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: