Provider Demographics
NPI:1114713245
Name:WOODS, KEELY
Entity type:Individual
Prefix:
First Name:KEELY
Middle Name:
Last Name:WOODS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 S 69TH ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-4346
Mailing Address - Country:US
Mailing Address - Phone:402-250-2682
Mailing Address - Fax:
Practice Address - Street 1:7405 S 69TH ST
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-4346
Practice Address - Country:US
Practice Address - Phone:402-250-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care