MEDICARE: THE GOOD SHEPHERD HOME HEALTHCARE 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	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1306528088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GOOD SHEPHERD HOME HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	6040 LAS VERDES LN
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68523-9348
Country	:	US
Telephone Number	:	240-408-1641
Fax Number	:

Provider Business Practice Location Address
First Line	:	6040 LAS VERDES LN
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68523-9348
Country	:	US
Telephone Number	:	240-408-1641
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARY GARNER
Credential	:
Telephone Number	:	240-408-1641

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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