Provider Demographics
NPI:1366447930
Name:MLB LINTON HEALTH FACILITIES, INC.
Entity Type:Organization
Organization Name:MLB LINTON HEALTH FACILITIES, INC.
Other - Org Name:LINTON HURSING AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-635-9500
Mailing Address - Street 1:1501 A ST NE
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-1607
Mailing Address - Country:US
Mailing Address - Phone:812-847-4426
Mailing Address - Fax:812-847-2947
Practice Address - Street 1:1501 A ST NE
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-1607
Practice Address - Country:US
Practice Address - Phone:812-847-4426
Practice Address - Fax:812-847-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15-5414Medicare ID - Type UnspecifiedMEDICARE PROVIDER