Individual
TERRY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7724 N 95TH AVE, OMAHA, NE 68122-1336
(531) 777-8372
Mailing address
7724 N 95TH AVE, OMAHA, NE 68122-1336
(531) 777-8372
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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