Provider Demographics
NPI:1952294357
Name:DEDICATED HOME CARE LLC
Entity type:Organization
Organization Name:DEDICATED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EYONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:443-629-1456
Mailing Address - Street 1:3314 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-4142
Mailing Address - Country:US
Mailing Address - Phone:240-486-2839
Mailing Address - Fax:
Practice Address - Street 1:3314 DECATUR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-4142
Practice Address - Country:US
Practice Address - Phone:240-486-2839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care