Organization Active NPI

Heavens Domain LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Omaha, NE
National Provider Identifier
1639051915
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
HEAVENS DOMAIN LLC
Practice address
3314 Decatur St
Omaha, NE 68111-4142
Phone
(301) 549-6872
NPI assigned
Jul 25, 2025
Last updated
Aug 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Authorized official

Name
Veronic AtagahNPI 1851180384
Title
Ceo
Phone
(302) 384-5822

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
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

3314 Decatur St
Omaha, NE 68111-4142

Mailing address

3314 Decatur St
Omaha, NE 68111-4142
Phone (301) 549-6872

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754956800000",
    "number": "1639051915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3314 DECATUR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681114142",
            "telephone_number": "301-549-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 DECATUR ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681114142",
            "telephone_number": "301-549-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENS DOMAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A",
        "authorized_official_last_name": "ATAGAH",
        "authorized_official_first_name": "VERONIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "302-384-5822"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "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 Aug 12, 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.