Koffi Dometo Aboki

Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Omaha, NE

NPI 1073328340 · NPPES record last updated Feb 12, 2025

Key facts

NPI
1073328340
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Practice address
7713 N 109TH St
Omaha, NE 68142-1161
Phone
(402) 813-1848
NPI assigned
Feb 12, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

7713 N 109TH St
Omaha, NE 68142-1161

Mailing address

7713 N 109TH St
Omaha, NE 68142-1161

Other providers in Omaha, NE

All providers in Omaha, NE · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Nebraska

Sources for this page

Verify at the official NPI Registry.