Provider Demographics
NPI:1740306349
Name:LINDA PERKINS HOME INC
Entity type:Organization
Organization Name:LINDA PERKINS HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-248-2286
Mailing Address - Street 1:304 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:MO
Mailing Address - Zip Code:65248-1269
Mailing Address - Country:US
Mailing Address - Phone:660-248-2286
Mailing Address - Fax:660-248-2930
Practice Address - Street 1:304 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1269
Practice Address - Country:US
Practice Address - Phone:660-248-2286
Practice Address - Fax:660-248-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities