Provider Demographics
NPI:1962846469
Name:LINDA KEDDY SERVICES INC
Entity Type:Organization
Organization Name:LINDA KEDDY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:KEDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-287-8583
Mailing Address - Street 1:5275 CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997
Mailing Address - Country:US
Mailing Address - Phone:772-287-8583
Mailing Address - Fax:772-266-4491
Practice Address - Street 1:5275 SE CHANNEL DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-3328
Practice Address - Country:US
Practice Address - Phone:772-287-8583
Practice Address - Fax:772-266-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906554311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6906554OtherSTATE OF FLORIDA ADULT FAMILY CARE HOME
FL=========OtherSTATE OF FL EIN