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COUNTRYHOUSE RESIDENCE
NPI 1477077808
Nursing Care in Lincoln, NE

Active since July 27, 2017CLIA 28D2115124 · Waiver
240 S 70TH ST, LINCOLN, NE 68510(402) 421-2200(531) 289-1494 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jul 27, 2017 (2 updates tracked since 2017).

About Countryhouse Residence NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRYHOUSE RESIDENCE (NPI 1477077808) is a healthcare organization registered as a nursing care in Lincoln, Nebraska and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through June 27, 2028 and lists Suzy Jessica Nootz, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1477077808
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NameLINCOLN COUNTRYHOUSE III, LLC
Location Address240 S 70TH STLincoln, NE 68510-2406
Mailing Address240 S 70th StLincoln, NE 68510-2406 · (402) 421-2200 · Fax (531) 289-1494
Phone(402) 421-2200
Fax(531) 289-1494
Organization SubpartNo
Authorized OfficialSuzy Jessica NootzExecutive Director · (402) 421-2200
Enumeration DateJuly 27, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1477077808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
License✔ Licensed in NE · ALF369
Definition
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.
240 S 70TH ST, Lincoln, NE 68510
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Other Names 1

Doing Business AsCountryhouse Residence

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 28D2115124

Countryhouse Residences · Lincoln, NE
Active · expires Jun 27, 2028
CLIA Number28D2115124
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 28, 2026
Certificate Expiration DateJune 27, 2028
Laboratory DirectorElizabeth Morales
Laboratory Phone(402) 421-2200
Laboratory LocationCountryhouse Residences240 South 70th, Lincoln, NE 68510
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMPOWERME ASL, LLC
Clinic/Center (Rehabilitation)
240 S 70TH ST
LINCOLN, NE 68510
Lancaster County (844) 502-7996
RILEY SARINE FOCHT
Occupational Therapist
240 S 70TH ST
LINCOLN, NE 68510
Lancaster County (402) 421-2200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lincoln Countryhouse III, LLC's NPI number?

The NPI number for Lincoln Countryhouse III, LLC is 1477077808. It was assigned to this organization in the NPPES registry on July 27, 2017. The provider is doing business as Countryhouse Residence.

Where is Lincoln Countryhouse III, LLC located?

Lincoln Countryhouse III, LLC is located at 240 S 70th St, Lincoln, NE 68510. The listed phone number is (402) 421-2200.

What is Lincoln Countryhouse III, LLC's specialty?

The primary specialty registered for this NPI is Nursing Care with taxonomy code 251J00000X.

Does Lincoln Countryhouse III, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 28D2115124) is associated with this NPI, valid through June 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lincoln Countryhouse III, LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.