Provider Demographics
NPI:1497549760
Name:ADDAH, BIENVENU YEMALIN
Entity type:Individual
Prefix:
First Name:BIENVENU
Middle Name:YEMALIN
Last Name:ADDAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11605 W DODGE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2566
Mailing Address - Country:US
Mailing Address - Phone:402-979-7770
Mailing Address - Fax:
Practice Address - Street 1:11605 W DODGE RD STE 4
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2566
Practice Address - Country:US
Practice Address - Phone:402-979-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities