Provider Demographics
NPI:1174171193
Name:PRAIRIE HILL HOME CARE, INC.
Entity type:Organization
Organization Name:PRAIRIE HILL HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:402-599-2503
Mailing Address - Street 1:7200 S 84TH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2116
Mailing Address - Country:US
Mailing Address - Phone:531-999-2503
Mailing Address - Fax:531-999-2504
Practice Address - Street 1:7200 S 84TH ST STE 6
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2116
Practice Address - Country:US
Practice Address - Phone:531-999-2503
Practice Address - Fax:531-999-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE531.999.2503OtherBUSINESS PHONE NUMBER