Provider Demographics
NPI:1043518798
Name:LINDBERG HEALTHCARE INC
Entity Type:Organization
Organization Name:LINDBERG HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-778-7378
Mailing Address - Street 1:2806 BECKY LN
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8516
Mailing Address - Country:US
Mailing Address - Phone:956-778-7378
Mailing Address - Fax:956-973-1942
Practice Address - Street 1:2806 BECKY LN
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8516
Practice Address - Country:US
Practice Address - Phone:956-778-7378
Practice Address - Fax:956-973-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0505930001Medicare NSC