1770004418 NPI number — HRS OF NEBRASKA, INC.

Table of content: (NPI 1770004418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770004418 NPI number — HRS OF NEBRASKA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HRS OF NEBRASKA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770004418
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17855 DALLAS PKWY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75287-6857
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-201-3779
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 S 74TH PLZ STE 111
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68114-4667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-999-6297
Provider Business Practice Location Address Fax Number:
402-769-2384
Provider Enumeration Date:
07/03/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SISCEL
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
Authorized Official Title or Position:
VP LEGAL
Authorized Official Telephone Number:
402-999-6297

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA201607 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10026689700 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: HHA201607 . This is a "NEBRASKA STATE LICENSE NUMBER" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com