MEDICARE: LINKS OF LIFE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency		NM

General Provider Information

NPI Number	:	1053617134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINKS OF LIFE LLC

Provider Business Mailing Address
First Line	:	1616 WINTON CIR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-1996
Country	:	US
Telephone Number	:	575-405-1169
Fax Number	:	575-522-2898

Provider Business Practice Location Address
First Line	:	1616 WINTON CIR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-1996
Country	:	US
Telephone Number	:	575-405-1169
Fax Number	:	575-522-2898

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MS. CHANDRA BAKER
Credential	:
Telephone Number	:	575-405-1169

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	02/07/2011

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