Provider Demographics
NPI:1326923210
Name:GRAND HORIZONS FAMILY LIVING LLC
Entity type:Organization
Organization Name:GRAND HORIZONS FAMILY LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-709-8492
Mailing Address - Street 1:3205 N 90TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-4714
Mailing Address - Country:US
Mailing Address - Phone:402-709-8492
Mailing Address - Fax:402-709-8492
Practice Address - Street 1:3205 N 90TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4714
Practice Address - Country:US
Practice Address - Phone:402-709-8492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty