Individual
RACHIDI FRAISE ADEDOKOUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4017 GREENE AVE, OMAHA, NE 68147-1819
(402) 686-6974
Mailing address
4017 GREENE AVE, OMAHA, NE 68147-1819
(402) 686-6974
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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