Provider Demographics
NPI:1962848762
Name:CARLIN SUPPORT COORDINATION, LLC
Entity Type:Organization
Organization Name:CARLIN SUPPORT COORDINATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/SUPPORT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:WSC
Authorized Official - Phone:386-490-0084
Mailing Address - Street 1:203 N INDUSTRIAL DR
Mailing Address - Street 2:SUITE 3 & 4
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7418
Mailing Address - Country:US
Mailing Address - Phone:386-490-0084
Mailing Address - Fax:866-300-0779
Practice Address - Street 1:203 N INDUSTRIAL DR
Practice Address - Street 2:SUITE 3 & 4
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7418
Practice Address - Country:US
Practice Address - Phone:386-490-0084
Practice Address - Fax:866-300-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty