Healthcare Provider Details

I. General information

NPI: 1982363172
Provider Name (Legal Business Name): LIVE WELL HOME CARE-NEBRASKA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 COMMERCE WAY
SOUTH SIOUX CITY NE
68776-3008
US

IV. Provider business mailing address

PO BOX 520
SOUTH SIOUX CITY NE
68776-0520
US

V. Phone/Fax

Practice location:
  • Phone: 402-494-9171
  • Fax: 402-870-5538
Mailing address:
  • Phone: 402-494-9171
  • Fax: 402-870-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA A GUTHMILLER
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 402-494-9171