Lincoln Countryhouse III, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

ALF369 Issued in NE

Legal business name

LINCOLN COUNTRYHOUSE III, LLC

Practice address

240 S 70TH St
Lincoln, NE 68510-2406

Phone

(402) 421-2200

Fax

(531) 289-1494

NPI assigned

Jul 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suzy Jessica Nootz

Title

Executive Director

Phone

(402) 421-2200

Specialties & licenses 1

Addresses

Other names 1

• CountryHouse Residence Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1477077808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102406",
            "telephone_number": "402-421-2200",
            "fax_number": "531-289-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102406",
            "telephone_number": "402-421-2200",
            "fax_number": "531-289-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTRYHOUSE III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NOOTZ",
        "authorized_official_first_name": "SUZY",
        "authorized_official_middle_name": "JESSICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-421-2200"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NE",
            "license": "ALF369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CountryHouse Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Care Agency in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Nursing Care Agency in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.