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General NPI Number Information
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NPI Number | 1720163298
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Entity Type | Organization
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Legal Business Name | TABITHA, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 4720 RANDOLPH STREET
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City | LINCOLN
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State | NE
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Zip | 68510-3741
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Country | US
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Telephone | 402-483-7671
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Fax | 402-486-8539
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Provider Business Mailing Address
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Address Line | 4720 RANDOLPH ST
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City | LINCOLN
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State | NE
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Zip | 68510-3741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR OF FINANCE
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Name | RENAE ENDICOTT
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Credential |
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Telephone | 402-484-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 501017
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License Number State | NE
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