CHIDAE SEVILLE GORDON

OMAHA, NE
NPI1407661564
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy253Z00000X In Home Supportive Care
Additional Taxonomies320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date2025-02-07
Last Update Date2025-03-12
Business Address
CHIDAE SEVILLE GORDON
6656 DECATUR ST
OMAHA, NE 68104-4641
Phone number: 469-358-4740
Mailing Address
CHIDAE SEVILLE GORDON
6656 DECATUR ST
OMAHA, NE 68104-4641
Phone number: 469-358-4740