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Organization

SACRED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAPORCHA KING (OWNER)
(402) 708-5888
Entity
Organization

Contact information

Practice address
7463 N 111TH ST, OMAHA, NE 68142-1522
(402) 708-5888
Mailing address
7463 N 111TH ST, OMAHA, NE 68142-1522

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other

Enumeration date
03/18/2025
Last updated
03/18/2025
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