Provider Demographics
NPI:1346463445
Name:LINA ADULT DAY CARE - COMMUNITY CENTER, LLC
Entity Type:Organization
Organization Name:LINA ADULT DAY CARE - COMMUNITY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLOVYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-288-4505
Mailing Address - Street 1:119 SANFORD ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1724
Mailing Address - Country:US
Mailing Address - Phone:203-288-4505
Mailing Address - Fax:203-288-1822
Practice Address - Street 1:119 SANFORD ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-1724
Practice Address - Country:US
Practice Address - Phone:203-288-4505
Practice Address - Fax:203-288-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4228484OtherPROVIDER NUMBER