Provider Demographics
NPI:1306528088
Name:THE GOOD SHEPHERD HOME HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:THE GOOD SHEPHERD HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-408-1641
Mailing Address - Street 1:6040 LAS VERDES LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68523-9348
Mailing Address - Country:US
Mailing Address - Phone:240-408-1641
Mailing Address - Fax:
Practice Address - Street 1:6040 LAS VERDES LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68523-9348
Practice Address - Country:US
Practice Address - Phone:240-408-1641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health