MEDICARE: FLAX HOLDINGS, 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	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720386956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLAX HOLDINGS, LLC

Provider Business Mailing Address
First Line	:	262 N UNIVERSITY AVE
Second Line	:
City	:	FARMINGTON
State	:	UT
Zip	:	84025-2975
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 LARKIN RD
Second Line	:
City	:	LIVE OAK
State	:	CA
Zip	:	95953-9599
Country	:	US
Telephone Number	:	530-695-8020
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	JOHN MITCHELL
Credential	:
Telephone Number	:	385-988-3319

Provider Enumeration Date	:	03/11/2011
Last Update Date	:	08/19/2024

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