=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942104575
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAILORED TOUCH CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3806 S 191ST ST
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68130-4303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-506-2072
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3806 S 191ST ST
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68130-4303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-506-2072
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER/CARE RELIABILITY SPECIALIST
-----------------------------------------------------
Name | MR. RANDY DILLON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-506-2072
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------