Organization
MATLOCK HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDI MATLOCK (OWNER)
(402) 359-3595
Entity
Organization
Contact information
Practice address
5510 MILLER AVE, RALSTON, NE 68127-3826
(402) 359-3595
Mailing address
5510 MILLER AVE, RALSTON, NE 68127-3826
(402) 359-3595
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120015510
—
NE
Enumeration date
01/03/2020
Last updated
01/03/2020
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