Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Daveontae Stark

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1942129655

Daveontae Stark is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Omaha, Nebraska. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026
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Practice location Address checks out

1805 N 73rd St
Omaha, NE 68114-1905
Phone: (402) 557-8583
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X

Record details

NPI number1942129655
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 15, 2026
Last updated in NPPESJuly 15, 2026
Certification dateJuly 15, 2026
Mailing address4111 N 33rd St, Omaha, NE 68111-2714

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