Individual
HUGUETTE B. CHANTAL GANLONON COOVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8924 N 161ST ST, BENNINGTON, NE 68007-6414
(402) 812-7271
Mailing address
3317 N 107TH ST, OMAHA, NE 68134-3664
(402) 502-1035
(402) 502-1478
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
000000
NE
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
0000000
NE
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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