Healthcare Provider Details
I. General information
NPI: 1952259293
Provider Name (Legal Business Name): NOUDEHOU LEON AMOUSSOU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/20/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1208 BELLEVUE BLVD N
BELLEVUE NE
68005-4011
US
IV. Provider business mailing address
1208 BELLEVUE BLVD N
BELLEVUE NE
68005-4011
US
V. Phone/Fax
- Phone: 402-657-8146
- Fax:
- Phone: 402-657-8146
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: