Provider Demographics
NPI:1760520837
Name:LINDEN UNIFIED SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LINDEN UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-887-3894
Mailing Address - Street 1:18527 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:CA
Mailing Address - Zip Code:95236
Mailing Address - Country:US
Mailing Address - Phone:209-887-3894
Mailing Address - Fax:
Practice Address - Street 1:18527 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:CA
Practice Address - Zip Code:95236
Practice Address - Country:US
Practice Address - Phone:209-887-3894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS3968577251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS3968577Medicaid