MEDICARE: LINDO'S HOUSE OF CARE INC

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	310400000X	Assisted Living Facility	AL11966	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AL11966	OTHER	FL	AGENCY FOR HEALTH CARE ADMINISTRATION

General Provider Information

NPI Number	:	1649565714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDO'S HOUSE OF CARE INC

Provider Business Mailing Address
First Line	:	6821 SW 8TH CT
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-2516
Country	:	US
Telephone Number	:	954-970-9915
Fax Number	:

Provider Business Practice Location Address
First Line	:	6821 SW 8TH CT
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-2516
Country	:	US
Telephone Number	:	954-970-9915
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MAE ADAMS
Credential	:	NURSE
Telephone Number	:	954-584-2124

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	06/16/2011

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