Individual
LATRENDA S CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 N 115TH ST STE 202, OMAHA, NE 68154-4419
(402) 359-1265
Mailing address
1055 N 115TH ST STE 202, OMAHA, NE 68154-4419
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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