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Individual

MRS. JOELLE ELODIE SE ADJINATA I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3509 HARRISON ST, BELLEVUE, NE 68147-1252
(402) 612-9032
Mailing address
3509 HARRISON ST, BELLEVUE, NE 68147-1252
(402) 612-9032

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
NE

Other

Enumeration date
03/20/2022
Last updated
03/20/2022
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