Life Community Outreach Center

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

LIFE COMMUNITY OUTREACH CENTER

Practice address

3536 N 40TH Ave
Omaha, NE 68111-2648

Phone

(531) 224-6446

NPI assigned

Jan 24, 2024

Last updated

Jan 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tylena TuckerNPI 1801660931

Title

Founder

Phone

(531) 224-6446

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Tylena Tucker

  • Chore Provider
  • Omaha, NE
  • NPI 1801660931
  NPD Authorized official
• Krizma Smith, HM

  • Community Health Worker
  • Omaha, NE
  • NPI 1780458240
  NPD

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1952163099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 N 40TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681112648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 N 40TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681112648",
            "telephone_number": "531-224-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE COMMUNITY OUTREACH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "TYLENA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "531-224-6446"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1801660931",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Lieske
• Sarah Lieske, LMHP
• Josephine Liess
• Courtney Jo Liester, MS, LMHP
• Life Balance Chiropractic
• Life Cycle Nutrition LLC
• Life Enhancement Services, LLC
• Life Source Chiropractic P.C.
• Lifechangers Academy Northampton LLC
• Lifeforge Counseling, LLC

• PACE Provider Organization in Omaha, NE
• Providers in Omaha, NE by specialty
• PACE Provider Organization in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.