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General NPI Number Information
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NPI Number | 1023901147
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Entity Type | Organization
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Legal Business Name | STAY GRACEFUL NEBRASKA INC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 8424 W CENTER RD STE 218
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City | OMAHA
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State | NE
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Zip | 68124-3138
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Country | US
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Telephone | 402-998-5238
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9743
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City | RAPID CITY
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State | SD
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Zip | 57709-9743
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Country | US
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Telephone | 605-519-3156
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ERIC WHITCHER
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Credential |
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Telephone | 605-519-3156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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