# LINCOLN COUNTRYHOUSE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205187069
- **Authorized official:** LAURA THELEN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (402) 499-1722

## Contact information

- **Practice address:** 5720 S 25TH ST, LINCOLN, NE 68512-2000
- **Practice address phone:** (402) 421-1160
- **Mailing address:** 5720 S. 25TH STREET, LINCOLN, NE 68512
- **Mailing address phone:** (402) 421-1160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | ALF327 | NE | Yes |

## Other

- **Enumeration date:** 09/19/2012
- **Last updated:** 09/19/2012