Provider Demographics
NPI:1801088059
Name:LINCOLN CHILD CENTER
Entity type:Organization
Organization Name:LINCOLN CHILD CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHIFT LEADER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:ZINDANI
Authorized Official - Suffix:I
Authorized Official - Credentials:BA
Authorized Official - Phone:510-531-3111
Mailing Address - Street 1:3524 FOOTHILL BLVD APT 9
Mailing Address - Street 2:3524 FOOTHILL BLVD APT 9
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-3644
Mailing Address - Country:US
Mailing Address - Phone:510-531-3111
Mailing Address - Fax:
Practice Address - Street 1:3524 FOOTHILL BLVD APT 9
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-3644
Practice Address - Country:US
Practice Address - Phone:510-531-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1Q1Y0800X322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children