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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821856832
- **Authorized official:** NATASHA Y JONES LPN (OWNER)
- **Authorized official phone:** (703) 731-4013

## Contact information

- **Practice address:** 7701 NORTH RIDGE DR, OMAHA, NE 68112-2322
- **Practice address phone:** (402) 915-1026
- **Mailing address:** 1314 S 12TH ST APT 110A, OMAHA, NE 68108-3856
- **Mailing address phone:** (703) 731-4013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/13/2024
- **Last updated:** 03/13/2024