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General NPI Number Information
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NPI Number | 1174171193
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Entity Type | Organization
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Legal Business Name | PRAIRIE HILL HOME CARE, INC.
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 7200 S 84TH ST STE 6
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City | LA VISTA
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State | NE
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Zip | 68128-2116
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Country | US
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Telephone | 531-999-2503
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Fax | 531-999-2504
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Provider Business Mailing Address
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Address Line | 7200 S 84TH ST STE 6
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City | LA VISTA
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State | NE
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Zip | 68128-2116
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Country | US
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Telephone | 531-999-2503
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Fax | 531-999-2504
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CHRISTY ELIZABETH NIELSEN
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Credential | RN, MSN
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Telephone | 402-599-2503
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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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