Nichole R Johnson
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Omaha, NE. Individual provider (NPI-1).
NPI number1831989573
StatusActive
Last updated in NPPESMay 7, 2025
Details
- NPI
- 1831989573
- Entity type
- Individual (NPI-1)
- Name
- Nichole R Johnson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 7, 2025
- Certification date
- May 7, 2025
- Last updated
- May 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
1805 N 73rd StOmaha, NE 68114-1905
Phone 402-557-8583
Mailing address
2873 Titus AveOmaha, NE 68112-3231
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