Healthcare Provider Details

I. General information

NPI: 1295521334
Provider Name (Legal Business Name): LIFESTYLES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1439 E 23RD ST
FREMONT NE
68025-2433
US

IV. Provider business mailing address

15418 W CENTER RD
OMAHA NE
68144-5400
US

V. Phone/Fax

Practice location:
  • Phone: 402-393-2354
  • Fax: 402-393-2509
Mailing address:
  • Phone: 402-393-2354
  • Fax: 402-393-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MARK BLIEFERNICH
Title or Position: PRESIDENT
Credential: CPO
Phone: 402-393-2354