NPIMap

Organization Active NPI

Golden Age Home Care LLC

  • In Home Supportive Care Agency
  • Omaha, NE
National Provider Identifier
1124810874
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GOLDEN AGE HOME CARE LLC
Practice address
9164 Taylor St
Omaha, NE 68134-4059
Phone
(402) 714-1606
NPI assigned
May 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mohammed Halid LassissiNPI 1497564850
Title
Owner
Phone
(402) 714-1606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

9164 Taylor St
Omaha, NE 68134-4059

Mailing address

9164 Taylor St
Omaha, NE 68134-4059
Phone (402) 714-1606

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1124810874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9164 TAYLOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681344059",
            "telephone_number": "402-714-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9164 TAYLOR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681344059",
            "telephone_number": "402-714-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "LASSISSI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "HALID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-714-1606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.