Healthcare Provider Details

I. General information

NPI: 1497478085
Provider Name (Legal Business Name): LINDENS HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 RIVER RD W
GOOCHLAND VA
23063-3203
US

IV. Provider business mailing address

PO BOX 82
GOOCHLAND VA
23063-0082
US

V. Phone/Fax

Practice location:
  • Phone: 804-658-8584
  • Fax:
Mailing address:
  • Phone: 804-658-8584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMY D NORRIS
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 804-658-8584