Individual
MR. XZAVIER JUANYA FORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4113 N 104TH PLZ, OMAHA, NE 68134-3781
(402) 212-6276
Mailing address
4113 N 104TH PLZ, OMAHA, NE 68134-3781
(402) 212-6276
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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