# POSITIVE DEVELOPMENTAL SUPPORTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114730165
- **Authorized official:** SHIINA HIROSE (DIRECTOR)
- **Authorized official phone:** (310) 614-4482

## Contact information

- **Practice address:** 4505 S 96TH ST, OMAHA, NE 68127-1212
- **Practice address phone:** (310) 614-4482
- **Mailing address:** 18121 VAN CAMP DR, OMAHA, NE 68130-4241
- **Mailing address phone:** (310) 614-4482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2025
- **Last updated:** 01/31/2025