Individual
ELORM KINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 N 39TH ST APT 2, OMAHA, NE 68131-2334
(646) 541-7167
Mailing address
1831 N 73RD ST, OMAHA, NE 68114
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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