MEDICARE: NORTHERN QUALITY HOME CARE SERVICES 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1073313185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN QUALITY HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	3314 MANDERSON ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68111-2834
Country	:	US
Telephone Number	:	402-212-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	3314 MANDERSON ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68111-2834
Country	:	US
Telephone Number	:	402-212-0044
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAREISHA NASHAE WASHINGTON
Credential	:
Telephone Number	:	402-212-0044

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	03/17/2025

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