Individual
GBENADE KOUAMI EDOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4611 S 96TH ST STE 235, OMAHA, NE 68127-1243
(402) 706-8625
Mailing address
7737 GREENLEAF DR, LA VISTA, NE 68128-2767
(402) 706-8625
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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