MEDICARE: SARAH DYH SIRAMA MAFICE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
2	372600000X	Adult Companion
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1164220463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DYH SIRAMA MAFICE

Provider Business Mailing Address
First Line	:	6818 GROVER ST STE 200
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68106-3632
Country	:	US
Telephone Number	:	402-932-0072
Fax Number	:	402-614-8245

Provider Business Practice Location Address
First Line	:	4412 N HWS CLEVELAND BLVD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68116-3062
Country	:	US
Telephone Number	:	531-210-6841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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