# TABITHA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tabitha Nursing and Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225117385
- **Authorized official:** RENAE ENDICOTT (ASSISTANT DIRECTOR OF FINANCE)
- **Authorized official phone:** (402) 484-9711

## Contact information

- **Practice address:** 4720 RANDOLPH STREET, LINCOLN, NE 68510-3741
- **Practice address phone:** (402) 483-7671
- **Practice address fax:** (402) 486-8539
- **Mailing address:** 4720 RANDOLPH ST, LINCOLN, NE 68510-3741
- **Mailing address fax:** (402) 486-8539

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 504009 | NE | — |
| 314000000X | Skilled Nursing Facility | 504009 | NE | Yes |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 12/12/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00525 | SNF (BCBS OF NE) | NE |
| 01 | — | 08982 | DME/SUPPLIES (BCBS OF NE) | NE |