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General NPI Number Information
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NPI Number | 1972302917
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Entity Type | Organization
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Legal Business Name | UNITED NEBRASKA HOME CARE REVIVAL LLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 6305 AMES AVE
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City | OMAHA
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State | NE
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Zip | 68104-2027
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Country | US
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Telephone | 888-226-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 6305 AMES AVE
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City | OMAHA
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State | NE
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Zip | 68104-2027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KENDA PRASEUTH
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Credential |
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Telephone | 402-518-0622
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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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