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Organization

SD HOME CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TYRONE SHIELDS (OWNER)
(402) 707-0909
Entity
Organization

Contact information

Practice address
5094 S 108TH ST, OMAHA, NE 68137-2314
(531) 777-8859
Mailing address
15130 BAUMAN AVE, OMAHA, NE 68116-4475
(402) 707-0909

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
251E00000X
Home Health Agency
Primary
342000000X
Transportation Network Company
347E00000X
Transportation Broker
364SH0200X
Home Health Clinical Nurse Specialist
3747P1801X
Personal Care Attendant
374U00000X
Home Health Aide
376J00000X
Homemaker

Other

Enumeration date
10/16/2023
Last updated
10/16/2023
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