Provider Demographics
NPI:1780481267
Name:DUET
Entity type:Organization
Organization Name:DUET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DSP
Authorized Official - Prefix:
Authorized Official - First Name:MELODY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-936-0492
Mailing Address - Street 1:16134 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2986
Mailing Address - Country:US
Mailing Address - Phone:402-936-0492
Mailing Address - Fax:
Practice Address - Street 1:16134 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2986
Practice Address - Country:US
Practice Address - Phone:402-936-0492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities