=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477835791
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINNCARE MANAGEMENT CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2011
-----------------------------------------------------
Last Update Date | 05/02/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 611 ZION ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75652-6565
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-889-2025
-----------------------------------------------------
Fax | 903-866-6770
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 611 ZION ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75652-6565
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-889-2025
-----------------------------------------------------
Fax | 903-866-6770
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR/ADMINISTRATOR
-----------------------------------------------------
Name | MRS. LINDA JOYCE HILL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 903-889-2025
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 14194
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------