Healthcare Provider Details

I. General information

NPI: 1285176107
Provider Name (Legal Business Name): LBHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 PIONEERS BLVD SUITE 202
LINCOLN NE
68502-5963
US

IV. Provider business mailing address

3201 PIONEERS BLVD SUITE 202
LINCOLN NE
68502-5963
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-9959
  • Fax: 402-489-2219
Mailing address:
  • Phone: 402-489-9959
  • Fax: 402-489-2219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONALD WILLIAM HOLMQUIST
Title or Position: OWNER
Credential: LMHP LDAC
Phone: 402-489-9959