Provider Demographics
NPI:1659745503
Name:UCP LAND OF LINCOLN
Entity Type:Organization
Organization Name:UCP LAND OF LINCOLN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:YARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:217-525-6522
Mailing Address - Street 1:101 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-1101
Mailing Address - Country:US
Mailing Address - Phone:217-525-6522
Mailing Address - Fax:217-525-9017
Practice Address - Street 1:101 N 16TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-1101
Practice Address - Country:US
Practice Address - Phone:217-525-6522
Practice Address - Fax:217-525-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child