Provider Demographics
NPI:1629183942
Name:LINDEN CENTER
Entity Type:Organization
Organization Name:LINDEN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EAVL
Authorized Official - Last Name:RIEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-251-8226
Mailing Address - Street 1:672 SOUTH LAFAYETTE PARK PLACE
Mailing Address - Street 2:SUITE 35
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3234
Mailing Address - Country:US
Mailing Address - Phone:213-251-8226
Mailing Address - Fax:213-251-8238
Practice Address - Street 1:672 SOUTH LAFAYETTE PARK PLACE
Practice Address - Street 2:SUITE 35
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3234
Practice Address - Country:US
Practice Address - Phone:213-251-8226
Practice Address - Fax:213-251-8238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1S19038261Q00000X
CA322D00000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children