Individual
BREANNA RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9251 KANSAS AVE APT C, OMAHA, NE 68122-2511
(402) 992-2962
Mailing address
9251 KANSAS AVE APT C, OMAHA, NE 68122-2511
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NE
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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