Provider Demographics
NPI:1225837024
Name:NEBRASKA INDEPENDENT LIVING CENTER
Entity type:Organization
Organization Name:NEBRASKA INDEPENDENT LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAPELIS MISSI
Authorized Official - Middle Name:
Authorized Official - Last Name:TIDJANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-791-6086
Mailing Address - Street 1:8903 N 161ST AVE
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-6417
Mailing Address - Country:US
Mailing Address - Phone:501-791-6086
Mailing Address - Fax:
Practice Address - Street 1:6550 S 84TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-4100
Practice Address - Country:US
Practice Address - Phone:501-791-6086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care