Individual
TONY DEMETRIUS ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2726 MARY ST, OMAHA, NE 68112-3218
(402) 612-1186
Mailing address
2726 MARY ST, OMAHA, NE 68112-3218
(402) 612-1186
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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