Provider Demographics
NPI:1760009161
Name:LINCOLNSHIRE RESIDENTIAL, LLC
Entity Type:Organization
Organization Name:LINCOLNSHIRE RESIDENTIAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:MELANIE
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-903-1285
Mailing Address - Street 1:30 LINCOLNSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4618
Mailing Address - Country:US
Mailing Address - Phone:817-903-1285
Mailing Address - Fax:
Practice Address - Street 1:30 LINCOLNSHIRE CIR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4618
Practice Address - Country:US
Practice Address - Phone:817-903-1285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health