Healthcare Provider Details

I. General information

NPI: 1841126216
Provider Name (Legal Business Name): DEKO ALI OMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 RIVERVIEW DR APT 1106
SOUTH SIOUX CITY NE
68776-3566
US

IV. Provider business mailing address

1101 RIVERVIEW DR APT 1106
SOUTH SIOUX CITY NE
68776-3566
US

V. Phone/Fax

Practice location:
  • Phone: 531-265-9168
  • Fax:
Mailing address:
  • Phone: 531-265-9168
  • 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: