Provider Demographics
NPI:1003118902
Name:LINDERS ADULT FAMILY CARE HOME
Entity Type:Organization
Organization Name:LINDERS ADULT FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-764-6219
Mailing Address - Street 1:431 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-5107
Mailing Address - Country:US
Mailing Address - Phone:904-764-6219
Mailing Address - Fax:
Practice Address - Street 1:431 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-5107
Practice Address - Country:US
Practice Address - Phone:904-764-6219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-27
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAF6905368311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141567100Medicaid