Healthcare Provider Details

I. General information

NPI: 1003979485
Provider Name (Legal Business Name): LINNHAVEN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 BLAIRS FERRY RD
MARION IA
52302-3013
US

IV. Provider business mailing address

1199 BLAIRS FERRY RD
MARION IA
52302-3013
US

V. Phone/Fax

Practice location:
  • Phone: 319-377-9788
  • Fax: 319-377-7641
Mailing address:
  • Phone: 319-377-9788
  • Fax: 319-377-7641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateIA

VIII. Authorized Official

Name: MS. DIANE MARIE PITLIK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 319-377-9788