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NPI Code Detail

MEDICARE: ELITE PROFESSIONALS HOME CARE LLC

MEDICARE: ELITE PROFESSIONALS HOME CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyHHA201604NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063433290
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE PROFESSIONALS HOME CARE LLC
Provider Business Mailing Address
First Line : 3901 FAULKNER DR.
Second Line :
City : LINCOLN
State : NE
Zip : 68516-4738
Country : US
Telephone Number : 402-464-2422
Fax Number : 402-464-2922
Provider Business Practice Location Address
First Line : 3901 FAULKNER DR.
Second Line :
City : LINCOLN
State : NE
Zip : 68516-4738
Country : US
Telephone Number : 402-464-2422
Fax Number : 402-464-2922
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : JENNIFER K GIBBONS
Credential : RN
Telephone Number : 402-464-2422
Provider Enumeration Date : 07/22/2006
Last Update Date : 11/10/2016

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Directions to “ELITE PROFESSIONALS HOME CARE LLC ” Practice Location

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