Organization
INDEPENDENCE AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE BRITT (EXECUTIVE DIRECTOR)
(308) 258-1914
Entity
Organization
Contact information
Practice address
910 AVENUE F, GOTHENBURG, NE 69138-2060
(308) 537-4332
(308) 537-4335
Mailing address
910 AVENUE F, GOTHENBURG, NE 69138-2060
(308) 537-4332
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
224ZR0403X
Driving and Community Mobility Occupational Therapy Assistant
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699267864
—
NE
Enumeration date
01/30/2013
Last updated
12/11/2019
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