Healthcare Provider Details

I. General information

NPI: 1992699227
Provider Name (Legal Business Name): ALI J OBADA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 SW 10TH ST APT 3
LINCOLN NE
68522-1264
US

IV. Provider business mailing address

9018 FORT ST
OMAHA NE
68134-1749
US

V. Phone/Fax

Practice location:
  • Phone: 531-289-9587
  • Fax:
Mailing address:
  • Phone: 531-289-9587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: