Individual provider · Type 1 NPI

Dietanurun Bose Omadevuae

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Orlando, FL

NPI number 1942881404 Active

Practice location

10920 Moss Park Rd
Orlando, FL 32832-6086

Call (407) 930-4339 Map

Fax (407) 745-1326

Mailing address

1092 Arlington Plaza, 1724
Omaha, NE 68164-5028

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1942881404

Dietanurun Bose Omadevuae's National Provider Identifier is 1942881404, issued on Apr 16, 2021. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Orlando, FL. The record was last updated on May 13, 2025.