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General NPI Number Information
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NPI Number | 1982739322
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Entity Type | Organization
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Legal Business Name | THE AMBASSADOR LINCOLN
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4405 NORMAL BLVD
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City | LINCOLN
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State | NE
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Zip | 68506-5551
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Country | US
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Telephone | 402-488-2355
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Fax |
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Provider Business Mailing Address
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Address Line | 2831 TIERRA DR APT 206
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City | LINCOLN
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State | NE
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Zip | 68516-5034
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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 | PHYSICAL THERAPIST ASSISTANT
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Name | KRISTINA KAY OBERG
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Credential |
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Telephone | 402-484-4512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 575
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License Number State | NE
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