Individual
ABDIRISAQ YUSUF MOHAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1503 N 104TH PLZ, OMAHA, NE 68114-1103
(531) 772-1207
Mailing address
1503 N 104TH PLZ, OMAHA, NE 68114-1103
(531) 772-1207
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
H13989145
NE
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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