Provider Demographics
NPI:1720255540
Name:LINDAS HOME WITH A HEART INC
Entity Type:Organization
Organization Name:LINDAS HOME WITH A HEART INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH-FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:253-537-4170
Mailing Address - Street 1:1705 88TH STREET EAST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-4117
Mailing Address - Country:US
Mailing Address - Phone:253-537-4170
Mailing Address - Fax:253-537-4216
Practice Address - Street 1:1705 88TH STREET EAST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-4117
Practice Address - Country:US
Practice Address - Phone:253-537-4170
Practice Address - Fax:253-537-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00034205164W00000X
WA575900311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty