Healthcare Provider Details

I. General information

NPI: 1154209120
Provider Name (Legal Business Name): CHOL AJOKSIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 W GARY GATELY ST APT 109C
LINCOLN NE
68528-1823
US

IV. Provider business mailing address

4915 W GARY GATELY ST APT 109C
LINCOLN NE
68528-1823
US

V. Phone/Fax

Practice location:
  • Phone: 402-817-4959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: