Individual
DEANDRE CAPRICE LERONE TABRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4729 CALIFORNIA ST APT 9, OMAHA, NE 68132-2528
(402) 739-2952
Mailing address
4729 CALIFORNIA ST APT 9, OMAHA, NE 68132-2528
(402) 739-2952
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H13067076
DRIVERS LICENSE
NE
Enumeration date
08/18/2025
Last updated
08/18/2025
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