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NPI 1710033139

NPI 1710033139 : LINCOLN IL/AL, LLC : LINCOLN, NE

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General NPI Number Information
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    NPI Number           |    1710033139
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    Entity Type          |    Organization 
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    Legal Business Name  |    LINCOLN IL/AL, LLC 
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Dates
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    Enumeration Date     |    01/26/2007
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    Last Update Date     |    05/03/2021
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Provider Practice Location Address
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    Address Line         |    6800 A ST 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68510-5134
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    Country              |    US
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    Telephone            |    402-483-1010
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    Fax                  |    402-483-2197
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Provider Business Mailing Address
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    Address Line         |    6800 A ST 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68510-5134
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    Country              |    US
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    Telephone            |    402-483-1010
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    Fax                  |    402-483-2197
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Authorized Official
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    Title or Position    |    AUTHORIZED SIGNATORY
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    Name                 |     JONATHAN  LITT 
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    Credential           |    
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    Telephone            |    646-844-3603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    310400000X
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    Taxonomy Name        |    Assisted Living Facility
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    License Number       |    
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    License Number State |    
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