Provider Demographics
NPI:1457169856
Name:HOME CARE ADVANTAGE, LLP
Entity type:Organization
Organization Name:HOME CARE ADVANTAGE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-510-6909
Mailing Address - Street 1:2646 Y ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-4417
Mailing Address - Country:US
Mailing Address - Phone:402-830-4790
Mailing Address - Fax:531-999-8791
Practice Address - Street 1:2646 Y ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-4417
Practice Address - Country:US
Practice Address - Phone:402-830-4790
Practice Address - Fax:531-999-8791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE32091758Medicaid