Provider Demographics
NPI:1073991410
Name:LNR ENTERPRISE, LLC
Entity Type:Organization
Organization Name:LNR ENTERPRISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:TRUDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-891-9313
Mailing Address - Street 1:1106 E BIRCHBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-4132
Mailing Address - Country:US
Mailing Address - Phone:801-891-9313
Mailing Address - Fax:801-613-9420
Practice Address - Street 1:1106 E BIRCHBROOK CIR
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-4132
Practice Address - Country:US
Practice Address - Phone:801-891-9313
Practice Address - Fax:801-613-9420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4866189-1205253Z00000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No253Z00000XAgenciesIn Home Supportive Care