Healthcare Provider Details

I. General information

NPI: 1659169043
Provider Name (Legal Business Name): DUKES VILLAGE DEVELOPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 S 42ND ST STE 107
OMAHA NE
68105-2942
US

IV. Provider business mailing address

PO BOX 34211
OMAHA NE
68134-0211
US

V. Phone/Fax

Practice location:
  • Phone: 402-578-8203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMADI WATTS
Title or Position: PRESIDENT
Credential:
Phone: 402-578-8203