Individual
DAH PO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3538 N 54TH ST, OMAHA, NE 68104-3516
(402) 541-9201
Mailing address
5530 N 61ST ST, OMAHA, NE 68104-1608
(531) 205-9945
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
About Stedi
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