Healthcare Provider Details

I. General information

NPI: 1659284636
Provider Name (Legal Business Name): MEH REH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 FORT ST
OMAHA NE
68104-1735
US

IV. Provider business mailing address

8620 N 96TH ST
OMAHA NE
68122-2300
US

V. Phone/Fax

Practice location:
  • Phone: 402-328-6242
  • Fax:
Mailing address:
  • Phone: 402-708-8209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: