Individual
LAPORCHA KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
319 S 17TH ST STE 708, OMAHA, NE 68102-1960
(402) 708-5888
Mailing address
7303 N 91ST ST, OMAHA, NE 68122-1221
(402) 708-5888
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
IA
Other
Enumeration date
04/08/2024
Last updated
05/29/2024
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