Provider Demographics
NPI:1699569376
Name:SIMPLY PAUSE, LLC
Entity type:Organization
Organization Name:SIMPLY PAUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PLMHP
Authorized Official - Phone:970-744-8629
Mailing Address - Street 1:663 N 132ND ST # 7147
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4031
Mailing Address - Country:US
Mailing Address - Phone:402-629-6394
Mailing Address - Fax:
Practice Address - Street 1:18911 L ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-3541
Practice Address - Country:US
Practice Address - Phone:402-629-6394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health