Individual
ANGELO D MELGOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PLADC
Contact information
Practice address
3483 LARIMORE AVE, OMAHA, NE 68111-2383
(402) 455-8303
(402) 455-7050
Mailing address
3483 LARIMORE AVE, OMAHA, NE 68111-2383
(402) 455-8303
(402) 455-7050
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
P-575
NE
Other
Enumeration date
02/15/2011
Last updated
02/15/2011
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