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

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1417746165

Koffi Nyuiemedi Ativon 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 2025.

In the registry since
2025
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Practice location Address checks out

2990 S 93rd Plz Apt 62
Omaha, NE 68124-2832
Phone: (402) 618-5006
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Specialties & licences

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

Record details

NPI number1417746165
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 30, 2025
Last updated in NPPESApril 30, 2025
Certification dateApril 30, 2025

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