Healthcare Provider Details

I. General information

NPI: 1366253080
Provider Name (Legal Business Name): BUBBLES AND BLOCKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4930 LINDBERG ST
LINCOLN NE
68516-6414
US

IV. Provider business mailing address

4930 LINDBERG ST # A
LINCOLN NE
68516-6414
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-0024
  • Fax:
Mailing address:
  • Phone: 402-488-0024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: NICOLE PECK
Title or Position: DIRECTOR
Credential:
Phone: 402-488-0024